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慢性阻塞性肺疾病患者在接种肺炎球菌结合疫苗前后的加重和肺炎比较,以及吸入皮质类固醇对结果的影响。

The comparison of exacerbation and pneumonia before and after conjugated pneumococcal vaccination in patients with chronic obstructive pulmonary disease, and the effect of inhaled corticosteroid use on results.

机构信息

Clinic of Pulmonary Diseases, University of Health Sciences Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey.

Clinic of Pulmonary Diseases, Bakırçay University Çiğli Training and Research Hospital, İzmir, Turkey.

出版信息

Tuberk Toraks. 2022 Jun;70(2):149-156. doi: 10.5578/tt.20229805.

Abstract

INTRODUCTION

Pneumococcal infections and exacerbations are important causes of mortality and morbidity in chronic obstructive pulmonary disease (COPD). The use of inhaled corticosteroids and pneumococcal vaccination are suggested for the control of the disease progression and exacerbations. The aim of this study is to assess the effect of pneumococcal conjugate vaccine on pneumonia and exacerbation in COPD patients using inhaled corticosteroids (ICSs). The secondary aim is to analyze the effect of ICS use and different ICS types, if administered, on exacerbation and pneumonia incidence in the study population.

MATERIALS AND METHODS

Medical records of 108 adult patients with COPD who were vaccinated with the pneumococcal conjugate vaccine (PCV13) were retrospectively evaluated. The number of acute exacerbations and pneumonia within one year before and after vaccination were evaluated in all included COPD patients. The comparison analysis was also performed based on the ICS types.

RESULT

There were statistically significant differences between the mean numbers of pneumonia and exacerbations before and after vaccination (p<0.05). There were no significant differences in the mean pneumonia attacks and acute exacerbations between patients using ICS and not using ICS (p> 0.05).

CONCLUSIONS

This study revealed that PCV13 provides a significant decrease in both exacerbation and pneumonia episodes in COPD patients. On the other hand, the use of ICSs and the types of ICSs were not found to have adverse effects on pneumonia and acute exacerbations in vaccinated COPD patients.

摘要

简介

肺炎球菌感染和恶化是慢性阻塞性肺疾病(COPD)患者死亡和发病的重要原因。吸入皮质类固醇和肺炎球菌疫苗接种被建议用于控制疾病进展和恶化。本研究旨在评估肺炎球菌结合疫苗对使用吸入皮质类固醇(ICSs)的 COPD 患者肺炎和恶化的影响。次要目的是分析 ICS 使用和不同 ICS 类型(如果使用)对研究人群中恶化和肺炎发生率的影响。

材料和方法

回顾性评估了 108 名接受肺炎球菌结合疫苗(PCV13)接种的成年 COPD 患者的病历。在所有纳入的 COPD 患者中,评估了接种前和接种后一年内急性恶化和肺炎的次数。还根据 ICS 类型进行了比较分析。

结果

接种前后肺炎和恶化的平均次数存在统计学差异(p<0.05)。使用 ICS 和不使用 ICS 的患者的肺炎发作和急性恶化的平均次数之间无显著差异(p>0.05)。

结论

本研究表明,PCV13 可显著降低 COPD 患者的恶化和肺炎发作次数。另一方面,ICS 的使用和 ICS 的类型并未发现对接种 COPD 患者的肺炎和急性恶化有不良影响。

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