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目的评价≥65岁老年人群接种三价流行性感冒病毒灭活疫苗(TIV)一年内的免疫持久性。方法检索美国国家医学图书馆数据库、Cochrane协作网图书馆、中国生物医学文献数据库、中国期刊全文数据库和万方全文数据库,收集2016年12月31日前公开发表的有关≥65岁老年人接种TIV一年内免疫持久性的研究,采用Cochrane协作组织2016年发布的随机对照试验偏倚评价工具和非随机对照试验偏倚评价工具进行文献质量评价。结果共纳入合格文献17篇。接种一年后,受种者总血凝抑制(HI)抗体几何平均滴度(GMT)与接种前比较,合并后标准化均数差(SMD)为0.10(95%CI:-0.12~0.32);针对A/H1N1、A/H3N2和B疫苗株的HI抗体GMT与接种前比较,合并后SMD分别为0.57(95%CI:0.23~0.91)、0.47(95%CI:-0.20~1.15)和-0.27(95%CI:-0.51~-0.04)。受种者HI总抗体血清保护率(SP)与接种前比较,其率差(RD)为0.06(95%CI:-0.04~0.16);针对A/H1N1、A/H3N2和B疫苗株的HI抗体SP与接种前比较,RD分别为0.09(95%CI:-0.15~0.33)、-0.08(95%CI:-0.28~0.13)和0.00(95%CI:-0.13~0.13)。结论≥65岁老年人接种TIV一年后HI抗体GMT和SP迅速衰减,建议开展更多的临床试验和卫生经济学研究评估≥65岁老年人群每年接种多剂次TIV免疫程序的可行性和成本效益。
Objective To evaluate the immune persistence within one year of vaccination of trivalent influenza virus inactivated vaccine (TIV) in the population of ≥65 years old. Methods The databases of the National Library of Medicine of the United States, the Cochrane Collaboration Library, the Chinese Biomedical Literature Database, the Chinese Journal Full-text Database and the Wanfang Full-text Database were searched and collected. The TIV-related information published before December 31, 2016 The year-to-year study of immune persistence was performed using the Cochrane Collaboration’s 2016 Randomized Controlled Trial Bias Rating Tool and the Non-Randomized Controlled Trial Bias Rating Tool for document quality evaluation. Results included 17 qualified documents. One year after inoculation, the mean geometric mean titer (GMT) of total HI was 0.10 (95% CI: -0.12-0.32). The HI antibody GMT against A / H1N1, A / H3N2 and B vaccine strains were 0.57 (95% CI: 0.23-0.91), 0.47 (95% CI: -0.20-1.15) and - 0.27 (95% CI: -0.51 ~ -0.04). The percentage of antibody (RD) was 0.06 (95% CI: -0.04 ~ 0.16) for the HI total antibody seroprotection rate (SP) of vaccinated subjects, and HI for A / H1N1, A / H3N2 and B vaccine strains The antibody SP was 0.09 (95% CI: -0.15 to 0.33), -0.08 (95% CI: -0.28 to 0.13) and 0.00 (95% CI: -0.13 to 0.13), respectively, before inoculation. CONCLUSIONS: One year after inoculation of TIV one year after inoculation with TIV, HI antibodies rapidly attenuate GMT and SP, suggesting that more clinical trials and health economics studies be conducted to evaluate the feasibility and cost of immunization schedule of multiple doses of TIV per year in ≥65 years old population benefit.