Department Family Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Neuroepidemiology. 2017;48(3-4):103-110. doi: 10.1159/000478017. Epub 2017 Jun 21.
Despite the presence of a strong association between influenza infection and stroke, whether influenza vaccination reduces the risk of stroke is yet a matter of controversy. We conducted a meta-analysis to determine whether influenza vaccination protects against stroke.
We searched PubMed, EMBASE, and the Cochrane Library from database inception date to November 18, 2016, without language restrictions, to identify studies investigating the effect of influenza vaccination on subsequent risk of stroke. We conducted a meta-analysis to quantify the risk of stroke in overall and subgroup analyses and calculated a pooled OR for developing stroke with a 95% CI. Publication bias was assessed by Begg's rank correlation test.
Eleven studies fulfilled our inclusion criteria. In a random-effects model, vaccinated individuals had a decreased risk of stroke compared with unvaccinated individuals (OR 0.82; 95% CI 0.75-0.91; p < 0.001). The relationship between influenza vaccination and stroke risk remained robust in subgroup analyses. The significant effect of influenza vaccination was associated with ascertainment of vaccination status and stage of prevention.
Vaccination against influenza is associated with a lower risk of stroke. Well-designed prospective studies are needed to provide stronger evidence of the protective effect of influenza vaccination against stroke.
尽管流感感染与中风之间存在很强的关联，但流感疫苗接种是否能降低中风风险仍存在争议。我们进行了一项荟萃分析，以确定流感疫苗接种是否能预防中风。
我们检索了 PubMed、EMBASE 和 Cochrane Library 数据库，检索时间从数据库建立到 2016 年 11 月 18 日，无语言限制，以确定研究流感疫苗接种对中风后续风险的影响。我们进行了荟萃分析，以量化整体和亚组分析中中风的风险，并计算了发展为中风的合并 OR 及其 95%CI。采用 Begg 秩相关检验评估发表偏倚。
11 项研究符合纳入标准。在随机效应模型中，与未接种疫苗者相比，接种疫苗者发生中风的风险降低（OR 0.82；95%CI 0.75-0.91；p<0.001）。亚组分析结果表明，流感疫苗接种与中风风险之间的关系仍然稳健。流感疫苗接种的显著效果与疫苗接种状态的确定和预防阶段有关。
流感疫苗接种与中风风险降低相关。需要设计良好的前瞻性研究来提供更强的证据，证明流感疫苗接种对中风的保护作用。
