Protasov A D, Zhestkov A V, Kostinov M P, Shteiner M L, Tezikov Yu V, Lipatov I S, Yastrebova N E, Kostinova A M, Ryzhov A A, Polishchuk V B
Samara State Medical University, Ministry of Health of Russia, Samara, Russia.
I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
Ter Arkh. 2017;89(12. Vyp. 2):165-174. doi: 10.17116/terarkh20178912165-174.
To assess the long-term clinical results of vaccination with pneumococcal polysaccharide and conjugated polysaccharide vaccines in the separate and sequential use, by determining the optimal vaccination schedule in adult patients with chronic obstructive pulmonary disease (COPD) and to investigate adaptive immunity levels.
The clinical effects of vaccination were evaluated in patients with COPD within 1 and 4 years after immunization against pneumococcal infection using various schemes, as well as the time course of changes in adaptive immunity indicators was examined.
Four years after vaccination, the 13-valent pneumococcal conjugate vaccine (PCV13)/23-valent pneumococcal polysaccharide vaccine (PPV23) group showed a decline in the number of patients with COPD exacerbations by 50% (p<0.001) and reductions in the number of antimicrobial chemotherapy cycles by 47.8% (p<0.001) and in that of hospitalizations by 87.5% (p<0.001). At 1 year after vaccination versus at baseline, the COPD patients vaccinated against pneumococcal disease, regardless of the drug and schedule of vaccination, displayed elevated levels of IgG antibodies to the mixture of capsular polysaccharides included in PPV23 and PCV13.
It has been indicated that a complex of basic therapy for patients with COPD should include initial vaccination with PCV13, followed by administration of a booster dose of PPV23.
通过确定慢性阻塞性肺疾病（COPD）成年患者的最佳疫苗接种方案，评估肺炎球菌多糖疫苗和结合多糖疫苗单独及序贯使用的长期临床效果，并研究适应性免疫水平。
采用不同方案对COPD患者进行肺炎球菌感染免疫接种后1年和4年内评估疫苗接种的临床效果，并检测适应性免疫指标的变化时间进程。
接种疫苗4年后，13价肺炎球菌结合疫苗（PCV13）/23价肺炎球菌多糖疫苗（PPV23）组COPD急性加重患者数量下降50%（p<0.001），抗菌化疗周期数减少47.8%（p<0.001），住院次数减少87.5%（p<0.001）。接种疫苗1年后与基线相比，无论接种何种药物和方案，接种肺炎球菌疾病疫苗的COPD患者针对PPV23和PCV13中包含的荚膜多糖混合物的IgG抗体水平均升高。
已表明COPD患者的基础治疗方案应包括先用PCV13进行初始接种，随后给予PPV23加强剂量。
