Division of Pulmonary Diseases, State Key Laboratory of Biotherapy, And Department of Respiratory and Critical Care Medicine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, 610041, China.
Department of Respiratory Medicine, Hospital of Chengdu office of People's Government of Tibetan Autonomous Region of China, Chengdu, Sichuan, 610041, China.
Ageing Res Rev. 2021 Jul;68:101337. doi: 10.1016/j.arr.2021.101337. Epub 2021 Apr 1.
Influenza is a threat to patients with chronic obstructive pulmonary disease (COPD), influenza vaccination help to reduce incidence of influenza infection, however, whether it is beneficial to COPD patients in clinical outcomes lacks for evidence due to limited studies and participations.
We searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI) and China Science and Technology Journal Database (CSTJ) to retrieve eligible studies regardless of study design published before August 2020, and conducted meta-analysis with odds ratio (OR) and mean difference (MD). The quality of included studies and pooled evidences were assessed. Narrative summaries were provided where data were insufficient for meta-analysis.
2831 COPD patients were included, the pooled results showed that influenza vaccination reduced the exacerbations (P = 0.0001) and trends of hospitalizations (P = 0.09) in COPD patients. Further subgroup analysis showed that the reduction of exacerbations and hospitalizations were significant in patients with FEV<50 % predicted (P = 0.01 and P < 0.0001 respectively), but not in those with FEV≥50 % predicted (P = 0.23 and P = 0.76 respectively). No significant effect of influenza vaccination on all-cause mortality was observed.
Our findings support a protective role of influenza vaccination in COPD patients, a yearly influenza vaccination should be strongly recommended for all COPD patients, especially those with severe airflow limitation, to reduce possible influenza infection, and thus associated exacerbations and hospitalizations.
流感对慢性阻塞性肺疾病（COPD）患者构成威胁，流感疫苗接种有助于降低流感感染的发生率，但由于研究和参与人数有限，对于流感疫苗接种是否对 COPD 患者的临床结局有益，尚无充分证据。
我们检索了 PubMed、Embase、Cochrane 图书馆、中国知网（CNKI）和中国科技期刊数据库（CSTJ），纳入了截至 2020 年 8 月发表的无论研究设计如何的合格研究，并用比值比（OR）和均数差（MD）进行荟萃分析。评估了纳入研究和汇总证据的质量。对缺乏荟萃分析数据的研究进行叙述性总结。
共纳入 2831 例 COPD 患者，汇总结果显示流感疫苗接种可降低 COPD 患者的加重（P = 0.0001）和住院趋势（P = 0.09）。进一步的亚组分析显示，在 FEV<50%预计值的患者中，疫苗接种可显著降低加重（P = 0.01）和住院（P < 0.0001）的发生率，但在 FEV≥50%预计值的患者中则无显著差异（P = 0.23 和 P = 0.76）。流感疫苗接种对全因死亡率无显著影响。
我们的研究结果支持流感疫苗接种对 COPD 患者具有保护作用，建议所有 COPD 患者，尤其是那些存在严重气流受限的患者，每年接种流感疫苗，以降低可能的流感感染风险，从而减少相关加重和住院。
