风湿免疫性疾病患者接种COVID-19疫苗安全性的研究

The Safety of COVID-19 Vaccine Accepted in Patients with Rheumatic Immune Diseases

摘要: 目的：探索风湿免疫病患者接种COVID-19疫苗后不良反应及疾病活动的发生率。方法：采用单中心横断面的调查方法，设计调查问卷，对2021.12.1~2022.5.30期间于我院风湿免疫科门诊就诊的患者进行问卷调查，入选明确诊断并至少接种1针COVID-19疫苗的风湿性疾病患者，详细记录其接种疫苗时的治疗药物使用情况，同时记录其出现的不良反应及疾病活动度的变化。结果：我们分析了276名接种COVID-19疫苗的风湿性疾病患者，平均年龄为48.8岁，26.1%为男性，73.9%为女性。最常见的风湿性疾病是类风湿关节炎(60.5%)，89.1%的患者正在服用抗风湿病药物。4例(3.4%)服用甲氨蝶呤的患者在疫苗接种时停用药物。接种COVID-19疫苗后，27例(9.8%)患者发生不良反应，报告最多的不良反应是关节/肌肉疼痛(13, 4.7%)和乏力(8, 2.9%)。仅有4例(1.4%)患者发生了疾病活动。结论：在接种COVID-19疫苗的风湿免疫病患者中，不良反应的发生率为9.8%，证明疫苗的安全性较高。应鼓励风湿免疫病患者接种COVID-19疫苗。同时风湿病医生应加强与患者的沟通，在疫苗接种时机方面提出有效的建议。

Abstract: Objective: To explore the incidence of adverse reactions and disease flares in patients with rheu-matic immunological diseases who received COVID-19 vaccination. Methods: A single-center cross- sectional survey was conducted between 2021.12.1 and 2022.5.30 in a random sample of rheuma-tology and immunology in the Affiliated Hospital of Qingdao University. Patients with rheumatic disease who received at least one dose of COVID-19 vaccine were enrolled into study. We need to record in detail the use of therapeutic drugs at the time of vaccination, as well as the occurrence of adverse reactions and disease flares. Results: We analyzed 276 patients with rheumatic diseases who received COVID-19 vaccination. The mean age was 48.8 years, 26.09% were male and 73.9% were female. The most common rheumatic disease was rheumatoid arthritis (60.5%), and 89.1% of patients were taking DMARDS. 4 patients (3.4%) taking methotrexate discontinued the drug around the time of vaccination. Adverse events occurred in 27 patients (9.8%) after COVID-19 vac-cination, with joint/muscle pain (13, 4.7%) and fatigue (8, 2.9%) being the most commonly report-ed adverse events. Only 4 patients (1.4%) had disease flares. Conclusion: The incidence of adverse reactions among patients with rheumatic immunological diseases who received COVID-19 vaccina-tion was 9.8%, indicating the high safety of the vaccine. People with rheumatic immunological dis-eases should be encouraged to be vaccinated against COVID-19. At the same time, rheumatologists should strengthen communication with patients and make effective recommendations on the tim-ing of vaccination.