Hedlund J U, Kalin M E, Ortqvist A B, Henrichsen J
Department of Infectious Diseases, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.
Arch Intern Med. 1994 Sep 12;154(17):1961-5.
A substantial proportion of patients admitted to the hospital for pneumonia have been treated in a hospital during the preceding 4 to 5 years, and patients previously treated in a hospital for pneumonia seem to be at an especially high risk for another episode of pneumonia. Many cases of pneumococcal infection might therefore be prevented by immunizing admitted patients with pneumococcal vaccine at discharge or at follow-up. The aim of this study was to investigate the type-specific antibody response to pneumococcal vaccine in middle-aged and elderly patients at follow-up 8 weeks after hospital treatment for pneumonia.
A total of 92 individuals, 50 to 85 years old, participated in the study. One group consisted of 65 individuals treated in the hospital for pneumonia 8 weeks before vaccination (mean age, 67 years), and another group consisted of 27 individuals who had not recently been treated for pneumonia (mean age, 67 years). All 92 individuals received a single dose of a 23-valent pneumococcal vaccine. The type-specific antibody responses to six pneumococcal capsular polysaccharide antigens included in the vaccine as well as antibodies against the 23-valent pneumococcal vaccine were measured before and 3 to 4 weeks after vaccination by use of an enzyme-linked immunosorbent assay.
The antibody concentrations before and after vaccination were comparable in the two groups, as were antibody fold increases from prevaccination to postvaccination serum. No serious adverse events were recorded.
Pneumococcal vaccination at follow-up 8 weeks after treatment in the hospital for pneumonia seems to elicit an adequate antibody response without notable adverse reactions.
因肺炎住院的患者中有很大一部分在之前4至5年内在医院接受过治疗,而且之前因肺炎在医院接受过治疗的患者似乎再次发生肺炎的风险特别高。因此,通过在出院时或随访时为住院患者接种肺炎球菌疫苗,可能预防许多肺炎球菌感染病例。本研究的目的是调查肺炎住院治疗后8周随访时中年和老年患者对肺炎球菌疫苗的型特异性抗体反应。
共有92名年龄在50至85岁之间的个体参与了该研究。一组由65名在接种疫苗前8周因肺炎在医院接受治疗的个体组成(平均年龄67岁),另一组由27名近期未因肺炎接受治疗的个体组成(平均年龄67岁)。所有92名个体均接种了一剂23价肺炎球菌疫苗。在接种疫苗前以及接种后3至4周,通过酶联免疫吸附测定法测量对疫苗中包含的六种肺炎球菌荚膜多糖抗原的型特异性抗体反应以及针对23价肺炎球菌疫苗的抗体。
两组接种疫苗前后的抗体浓度相当,从接种前到接种后血清的抗体倍数增加也相当。未记录到严重不良事件。
肺炎住院治疗后8周随访时接种肺炎球菌疫苗似乎能引发足够的抗体反应,且无明显不良反应。