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[流感:老年群体的特殊情况]

[Influenza: special aspects in old age].

作者信息

Kwetkat A, Leischker A, Heppner H J

机构信息

Klinik für Geriatrie, Universitätsklinikum Jena, Bachstr. 18, 07743, Jena, Deutschland.

Arbeitsgruppe Impfen, Deutsche Gesellschaft für Geriatrie e. V. (DGG), Berlin, Deutschland.

出版信息

Z Gerontol Geriatr. 2018 Jul;51(5):585-596. doi: 10.1007/s00391-018-1418-4. Epub 2018 Jun 27.

Abstract

In Germany up to 20% of the population are affected by influenza every year. Particularly for the elderly, influenza is related to high morbidity and mortality and 90% of deaths are related to the group of 60 years and older. In this context, seasonal influenza caused by influenza A (H3N2) viruses is exceedingly relevant for the elderly. The aging of the immune system, immunosenescence, is well documented as the cause of increased susceptibility to infection and change of typical symptoms. This can cause a delay in diagnosing and treatment of influenza infections. Furthermore, immunosenescence can lead to decreased efficacy of vaccination. Adjuvanted vaccines and vaccines with higher antigen content cause an enhanced immune response and are therefore especially suitable for prevention. The Standing Vaccination Committee (STIKO) recommends vaccination against seasonal influenza for all persons 60 years of age and over as well as for nursing home residents, pregnant women and chronically ill patients. For the coming influenza season 2018/19, the STIKO generally recommends the administration of quadrivalent (tetravalent) vaccines for the first time.

摘要

在德国,每年有高达20%的人口受到流感影响。特别是对于老年人来说,流感与高发病率和高死亡率相关,90%的死亡病例与60岁及以上人群有关。在这种情况下,甲型(H3N2)病毒引起的季节性流感对老年人极为重要。免疫系统的老化,即免疫衰老,被充分证明是导致感染易感性增加和典型症状改变的原因。这可能导致流感感染的诊断和治疗延迟。此外,免疫衰老会导致疫苗接种效果下降。佐剂疫苗和抗原含量更高的疫苗会引起更强的免疫反应,因此特别适合用于预防。常设疫苗接种委员会(STIKO)建议60岁及以上的所有人、养老院居民、孕妇和慢性病患者接种季节性流感疫苗。对于即将到来的2018/19流感季节,STIKO首次普遍建议使用四价疫苗。

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