Chalmers A, Scheifele D, Patterson C, Williams D, Weber J, Shuckett R, Teufel A
Department of Medicine, University of British Columbia, Vancouver, Canada.
J Rheumatol. 1994 Jul;21(7):1203-6.
To address the issues of immunogenicity and local and systemic reactions to vaccination with influenza vaccine in patients with rheumatoid arthritis (RA).
One hundred and twenty-six patients with RA were stratified into 3 groups: (1) those with a history of vaccination with influenza vaccine within 24 months who were receiving usual therapy for RA, (2) those receiving usual therapy for RA but without prior vaccine, and (3) those receiving immunosuppressive medication or prednisone > or = 7.5 mg/day, irrespective of their prior immunization status. Within each group, patients were randomized to receive vaccine or placebo. A group of age matched, healthy controls were also vaccinated.
During a one month followup period, adverse reactions occurred with equal frequency among patients with RA and healthy controls. Similar significant increases in titers to the vaccine were seen in all groups of patients with arthritis and in the controls.
The potential increase in susceptibility to influenza and death from respiratory illness in patients with RA and the demonstrated safety and immunogenicity of influenza vaccine should require the inclusion of patients with RA in standard immunization programs.
解决类风湿关节炎（RA）患者接种流感疫苗后的免疫原性以及局部和全身反应问题。
126例RA患者被分为3组：（1）在24个月内有流感疫苗接种史且正在接受RA常规治疗的患者；（2）接受RA常规治疗但无先前疫苗接种史的患者；（3）接受免疫抑制药物或泼尼松≥7.5mg/天的患者，无论其先前的免疫状态如何。在每组中，患者被随机分配接受疫苗或安慰剂。一组年龄匹配的健康对照者也接种了疫苗。
在1个月的随访期内，RA患者和健康对照者出现不良反应的频率相同。所有关节炎患者组和对照组对疫苗的抗体滴度均有类似的显著升高。
RA患者对流感的易感性以及因呼吸道疾病死亡的可能性增加，且流感疫苗已证明具有安全性和免疫原性，这应促使在标准免疫计划中纳入RA患者。
