Wen Y, He L, Zhai Y, Wu J, Chen Y Y, Wang H, Zong Q Q, Liang X F
Division of Non-communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Department of Applied Economics, Guanghua School of Management, Peking University, Beijing 100871, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Jun 10;39(6):792-798. doi: 10.3760/cma.j.issn.0254-6450.2018.06.019.
To explore the effect of influenza and 23 valent pneumococcal polysaccharide pneumococcal vaccinations on symptom-improvement among elderly with chronic obstructive pulmonary diseases (COPD). Data was gathered from 4 communities in 3 National Demonstration Areas set for comprehensive prevention and control of chronic non- communicable diseases in Chongqing city and Ningbo city respectively, from November 2013 to October 2014. The communities were selected by cluster sampling and divided into 4 groups: (1) injected influenza vaccines; (2) injected with pneumococcal vaccines; (3) received both of the two vaccines; (4) the control group that without any intervention measures. All the subjects aged from 60 to 75 were selected to fill in demographic information questionnaire and receive (COPD assessment test, CAT) scores twice, before intervention and 1 year after the vaccination. SAS 9.4 software was used to analyze the change of symptoms and CAT scores before and after the intervention program and comparing the improvement on symptoms among the elderly people under study. A total of 1 244 subjects with nearly same baseline conditions after the propensity score matching, were involved in this study. CAT scores appeared as =21 (: 17-26) at baseline. The CAT scores appeared as =18 (: 14-24), decreasing in all the 3 vaccinated groups, one year after the intervention program (influenza vaccines, matching test, =-6.531, =0.403; pneumococcal vaccines, Wilcoxon test, =-9 623, <0.001; combined vaccine vaccines, matching test, =-10.803, <0.001). However, in the control group, no obvious change was observed (Wilcoxon =1 167, =0.403). Proportions of impacts at high or very high levels all decreased in the 3 intervention groups, while little change was observed in the control group. Outcomes from the Factorial analysis suggested that influenza vaccination could improve the general conditions and symptoms including cough, chest tightness, dyspnea, physical activities, and stamina. Pneumococcal vaccination appeared more effective on all of symptoms and indicators. Pneumococcal and influenza vaccination seemed helpful for elderly people suffering COPD to improve the general health condition.
探讨流感疫苗和23价肺炎球菌多糖疫苗接种对慢性阻塞性肺疾病（COPD）老年患者症状改善的影响。分别于2013年11月至2014年10月从重庆市和宁波市3个国家慢性病综合防控示范区的4个社区收集数据。采用整群抽样法选取社区，并将其分为4组：（1）注射流感疫苗组；（2）注射肺炎球菌疫苗组；（3）两种疫苗都接种组；（4）无任何干预措施的对照组。选取所有年龄在60至75岁的受试者填写人口统计学信息问卷，并在干预前和接种疫苗1年后两次接受慢性阻塞性肺疾病评估测试（CAT）评分。使用SAS 9.4软件分析干预前后症状和CAT评分的变化，并比较研究中老年人症状的改善情况。共有1244名受试者在倾向得分匹配后基线条件相近，参与了本研究。基线时CAT评分为21（四分位间距：17 - 26）。干预项目1年后，所有3个接种疫苗组的CAT评分均出现下降，分别为18（四分位间距：14 - 24）（流感疫苗，配对检验，t = -6.531，P = 0.403；肺炎球菌疫苗，Wilcoxon检验，Z = -9.623，P < 0.001；联合疫苗，配对检验，t = -10.803，P < 0.001）。然而，对照组未观察到明显变化（Wilcoxon Z = 1.167，P = 0.403）。3个干预组中高或非常高水平影响的比例均下降，而对照组变化不大。析因分析结果表明，流感疫苗接种可改善包括咳嗽、胸闷、呼吸困难、体力活动和耐力等总体状况和症状。肺炎球菌疫苗接种对所有症状和指标似乎更有效。肺炎球菌疫苗和流感疫苗接种似乎有助于患有COPD的老年人改善总体健康状况。
