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肾综合征出血热灭活疫苗的保护效力:一项荟萃分析。

The protective efficacy of inactivated vaccine against hemorrhagic fever with renal syndrome: A meta-analysis.

作者信息

Wu Weiting, Liu Jie, Guo Shicheng, Zhao Han, Yang Xuli

机构信息

Youth Research and Innovation Team of Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China.

School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.

出版信息

Medicine (Baltimore). 2025 May 16;104(20):e42463. doi: 10.1097/MD.0000000000042463.

Abstract

BACKGROUND

Hemorrhagic fever with renal syndrome (HFRS) is a kind of natural epidemic diseases with rodents as the main source of infection. The main clinical manifestations of HFRS are fever, hemorrhage, congestion, hypotensive shock and kidney damage. Some studies showed that vaccination populations in infected areas with inactivated vaccines can reduce the incidence of the disease, but there are variations in protection rates among these studies. The aim of this study is to systematically evaluate the protective effect of inactivated vaccines against HFRS.

METHODS

Web of Science, PubMed, SinoMed, Proquest, China National Knowledge Infrastructure Database, Wanfang Database, VIP Database were searched from their inception to December 2024. Newcastle-Ottawa Scale (NOS) was used to assess the quality of evidence, and a random-effects meta-analysis was done to calculate pooled risk ratios for vaccination uptake. All the relevant data were analyzed by using STATA 15.0.

RESULTS

A total of 15 articles were included, all of which explicitly reported the total number of vaccinated and unvaccinated people in the vaccination group, and the number of cases that developed during the observation period. Six of these articles reported positive antibody transfer rates. The protection rate of the inactivated HFRS vaccine reached 86%, and a subgroup analysis showed that there was a significant difference in the protection rate of the inactivated vaccine between Korea and China. The positive IgG antibody transfer rate was 97%, and neutralizing antibody transfer rate was 37%.

CONCLUSION

The results indicated that inactivated vaccine has a good protective effect against HFRS and should be universally administered to populations in high prevalence areas to control the harm caused by HFRS epidemics.

摘要

背景

肾综合征出血热(HFRS)是一种以啮齿动物为主要传染源的自然疫源性疾病。HFRS的主要临床表现为发热、出血、充血、低血压休克和肾脏损害。一些研究表明,在疫区用灭活疫苗对人群进行接种可降低该病的发病率,但这些研究的保护率存在差异。本研究旨在系统评价灭活疫苗对HFRS的保护效果。

方法

检索Web of Science、PubMed、中国生物医学文献数据库、Proquest、中国知网数据库、万方数据库、维普数据库,检索时间从建库至2024年12月。采用纽卡斯尔-渥太华量表(NOS)评估证据质量,并进行随机效应荟萃分析以计算接种疫苗的合并风险比。所有相关数据均使用STATA 15.0进行分析。

结果

共纳入15篇文章,所有文章均明确报告了接种组接种和未接种人群的总数以及观察期内发病的病例数。其中6篇文章报告了阳性抗体转化率。HFRS灭活疫苗的保护率达到86%,亚组分析显示韩国和中国的灭活疫苗保护率存在显著差异。阳性IgG抗体转化率为97%,中和抗体转化率为37%。

结论

结果表明,灭活疫苗对HFRS具有良好的保护作用,应在高流行地区对人群普遍接种,以控制HFRS流行造成的危害。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f43f/12091670/8e24e47ce79f/medi-104-e42463-g001.jpg

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