23价肺炎疫苗联合流感疫苗接种对慢性阻塞性肺疾病影响的Meta分析

Meta-Analysis of the Effect of 23 Valent Pneumonic Vaccine Combined with Influenza Vaccine on Chronic Obstructive Pulmonary Disease

摘要: 目的：比较23价肺炎球菌多糖疫苗、流感疫苗联合接种和常规治疗对慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease COPD)患者的临床防治效果。方法：检索时间从各数据库建库时间至2022年6月的中英文数据库。阅读相关文献，根据纳入与排除标准筛选文献提取资料，对文献质量进行评价，采用RevMan5.4软件进行分析。结果：共纳入12篇文献，1416个研究对象，其中干预组占699个，对照组717个。进行荟萃分析后结果显示，23价肺炎球菌疫苗联合流感疫苗可缩短COPD患者平均住院天数(WMD = −4.35, 95% CI = −4.50~−4.21, P < 0.00001)、减少COPD急性发作次数(WMD = −4.31, 95% CI = −4.46~−4.17, P < 0.00001)、降低COPD患者全因死亡风险(RR = 0.23, 95% CI = 0.14~0.38, P < 0.00001)。结论：23价肺炎球菌多糖疫苗与流感疫苗的联合接种对于减少COPD患者的急性发作次数、降低死亡风险、缩短住院天数有着积极作用；但是由于方法学原因及文献质量高低不一，需要更多科学、严谨、质量高的研究验证疫苗联合接种效果。

Abstract: Objective: To compare the clinical prevention and treatment effects of 23 valent pneumococcal pol-ysaccharide vaccine combined with influenza vaccine and routine treatment on patients with chronic obstructive pulmonary disease (COPD). Methods: Related literatures were read from Chi-nese and English databases from the establishment time of each database to June 2022. The litera-tures were screened and extracted according to inclusion and exclusion criteria, and the literature quality was evaluated. RevMan5.4 software was used for analysis. Results: A total of 1416 subjects were included in 12 studies, including 699 in the intervention group and 717 in the control group. Meta-analysis showed that 23-valent pneumococcal vaccine combined with influenza vaccine re-duced the average length of hospital stay in COPD patients (WMD = −4.35, 95% CI = −4.50 to −4.21, P < 0.00001), reduced the number of COPD acute (WMD = −4.31, 95% CI = −4.46~−4.17, P < 0.00001), reduced the risk of all-cause death in COPD patients (RR = 0.23, 95% CI = 0.14~0.38, P < 0.00001). Conclusion: The combined administration of 23 valent pneumococcal polysaccharide vac-cine and influenza vaccine has a positive effect on reducing the number of acute episodes in COPD patients, reducing the risk of death and shortening the length of hospital stay; However, due to methodological reasons and different literature quality, more scientific and rigorous high-quality studies are needed to verify the effect of combined vaccination.