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研究在英国儿科队列中炎症性肠病与轮状病毒疫苗接种之间的关联。

Investigating association between inflammatory bowel disease and rotavirus vaccination in a paediatric cohort in the UK.

机构信息

Institute of Population Health, Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK.

NIHR HPRU in Gastrointestinal Infections at University of Liverpool, Liverpool, UK.

出版信息

Epidemiol Infect. 2023 Jun 9;151:e103. doi: 10.1017/S0950268823000936.

Abstract

In the UK, the incidence and prevalence of inflammatory bowel disease (IBD) is increasing in paediatric populations. Environmental factors including acute gastroenteritis episodes (AGE) may impact IBD development. Infant rotavirus vaccination has been shown to significantly reduce AGE. This study aims to explore the association between vaccination with live oral rotavirus vaccines and IBD development. A population-based cohort study was used, analysing primary care data from the Clinical Practice Research Datalink Aurum. Participants included children born in the UK from 2010 to 2015, followed from a minimum of 6 months old to a maximum of 7 years old. The primary outcome was IBD, and the primary exposure was rotavirus vaccination. Cox regression analysis with random intercepts for general practices was undertaken, with adjustment for potential confounding factors. In a cohort of 907,477 children, IBD was recorded for 96 participants with an incidence rate of 2.1 per 100,000 person-years at risk. The univariable analysis hazard ratio (HR) for rotavirus vaccination was 1.45 (95% confidence interval (CI) 0.93-2.28). Adjustment in the multivariable model attenuated the HR to 1.19 (95% CI 0.53-2.69). This study shows no statistically significant association between rotavirus vaccination and development of IBD. However, it provides further evidence for the safety of live rotavirus vaccination.

摘要

在英国,儿童群体中炎症性肠病(IBD)的发病率和流行率正在上升。环境因素,包括急性肠胃炎发作(AGE),可能会影响 IBD 的发展。婴儿轮状病毒疫苗接种已被证明可显著减少 AGE。本研究旨在探讨口服活轮状病毒疫苗接种与 IBD 发展之间的关联。采用基于人群的队列研究,分析来自临床实践研究数据链接 Aurum 的初级保健数据。参与者包括 2010 年至 2015 年在英国出生的儿童,从至少 6 个月大到最大 7 岁进行随访。主要结局是 IBD,主要暴露是轮状病毒疫苗接种。采用具有一般实践随机截距的 Cox 回归分析,并调整潜在的混杂因素。在一个 907477 名儿童的队列中,有 96 名儿童记录到 IBD,发病率为每 100000 人年风险 2.1 例。单变量分析的轮状病毒疫苗接种风险比(HR)为 1.45(95%置信区间(CI)0.93-2.28)。多变量模型中的调整将 HR 减弱至 1.19(95%CI 0.53-2.69)。本研究表明轮状病毒疫苗接种与 IBD 发展之间没有统计学上的显著关联。然而,它为活轮状病毒疫苗接种的安全性提供了进一步的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e0b/10311680/5aef7bdf2bdd/S0950268823000936_fig1.jpg

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