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预防医学  2019, Vol. 31 Issue (3): 265-270    DOI: 10.19485/j.cnki.issn2096-5087.2019.03.011
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人用H7N9禽流感灭活疫苗免疫效果评价的Meta分析
伍小雪1, 苟晓琴1, 石渝2, 张柯1, 钱媛1, 苏敏1, 黄俊琼1
1.遵义医科大学附属医院检验科,贵州 遵义 563000;
2.垫江县人民医院
Meta-analysis of the immune effects of inactivated H7N9 influenza vaccine
WU Xiao-xue*, GOU Xiao-qin, SHI Yu, ZHANG Ke, QIAN Yuan, SU Min, HUANG Jun-qiong
*Clinical Lab of The Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou 563000,China
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摘要 目的 了解人用H7N9禽流感灭活疫苗的免疫效果。方法 以H7N9和vaccine等关键词检索The Cochrane Library、PubMed等英文数据库,以H7N9禽流感和疫苗等关键词检索中国生物医学文献数据库、中国知网等中文数据库,获取建库至2018年7月10日公开发表的关于人用H7N9禽流感疫苗免疫效果的科技文献,根据纳入和排除标准筛选文献并评估研究质量后,以接种疫苗后的血清转换率(SCR)为结局指标分析剂量、佐剂对免疫效果的影响。结果 检索到1 679篇文献,最终纳入研究灭活疫苗的文献5篇,研究样本量2 579人。Meta分析结果显示,接种第1剂后各个剂量组的SCR的率差(RD)为1%~10%,免疫效果差;接种2剂后,未使用佐剂疫苗SCR的RD值为13%~19%,仍不能起保护作用;使用佐剂疫苗SCR的RD值为62%~69%,均达到流感疫苗许可标准;2剂均使用佐剂的疫苗免疫效果优于仅第1剂使用佐剂(RR=1.19,95%CI:1.02~1.39);以AS03和MF59为佐剂的疫苗接种最低剂量3.75 μg即可获得与15 μg相当的免疫效果,接种2剂后SCR的RD值分别为89%(95%CI:85%~93%)和42%(95%CI:9%~75%),AS03佐剂疫苗的免疫效果优于MF59佐剂。结论 H7N9禽流感灭活疫苗在联合使用佐剂的情况下接种2剂可取得较好的免疫效果,最低有效剂量为3.75 μg。
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伍小雪
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钱媛
苏敏
黄俊琼
关键词 H7N9禽流感灭活疫苗免疫效果Meta分析    
AbstractObjective To evaluate the immune effects of inactivated H7N9 influenza vaccine.Methods We searched several common databases(The Cochrane Library,PubMed,China Biology Medicine disc,China National Knowledge Infrastructure,etc.)for research articles about immune effects of H7N9 influenza vaccine published from the time the database built to July 10th of 2018,using H7N9 and vaccine as keywords. After screening the articles according to the inclusion and exclusion criteria,we assessed the quality of the studies and then employed seroconversion rate(SCR)as an outcome indicator to analyze the immune effects of different doses and adjuvants.Results We recruited 5 articles on inactivated H7N9 influenza vaccine from 1 679 articles. The sample size was 2 579. The results of the meta-analysis showed that the rate difference(RD)values of SCR in each dose group after the first dose ranged from 1% to 10%,which indicated a poor protective effect;after the second dose of immunization,the RD values of SCR in the vaccines without adjuvants ranged from 13% to 19%,which was not effective enough;the RD values of SCR in the vaccines with adjuvants ranged from 62% to 69%,which met the licensing criteria for influenza vaccine;better results could be achieved when immunized with two doses of vaccines with adjuvants( RR=1.19,95%CI:1.02-1.39);vaccines with AS03 or MF59 at the lowest dose of 3.75 μg had the same immune effects as ones at a dose of 15 μg;vaccines with AS03(RD=89%,95%CI:85%-93%)were superior to those with MF59(RD=42%,95%CI:9%- 75%).Conclusion Inactivated H7N9 influenza vaccines could achieve good immune effects when inoculated two doses with adjuvants,and the minimum effective dose was 3.75 μg.
Key wordsH7N9    Avian influenza    Inactivated vaccine    Meta-analysis
收稿日期: 2018-10-10      出版日期: 2019-03-04
ZTFLH:  R511.7  
  R186  
通信作者: 黄俊琼,E-mail:543369692@qq.com   
作者简介: 伍小雪,硕士在读
引用本文:   
伍小雪, 苟晓琴, 石渝, 张柯, 钱媛, 苏敏, 黄俊琼. 人用H7N9禽流感灭活疫苗免疫效果评价的Meta分析[J]. 预防医学, 2019, 31(3): 265-270.
WU Xiao-xue, GOU Xiao-qin, SHI Yu, ZHANG Ke, QIAN Yuan, SU Min, HUANG Jun-qiong. Meta-analysis of the immune effects of inactivated H7N9 influenza vaccine. Preventive Medicine, 2019, 31(3): 265-270.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2019.03.011      或      http://www.zjyfyxzz.com/CN/Y2019/V31/I3/265
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