综合性干预预防老年患者社区获得性下呼吸道感染的研究

Comprehensive interventions to prevent community-acquired lower respiratory tract infections in the elderly

目的评价肺炎链球菌疫苗联合防误吸药物莫沙比利,在预防老年患者社区获得性下呼吸道感染中的作用,有效降低其感染率。方法选择发生下呼吸道感染高危因素的社区老年患者210例,随机分为综合干预组、疫苗组、对照组3组,每组各70例,分别给予肺炎球菌多价疫苗注射+莫沙比利片口服、肺炎球菌多价疫苗注射+莫沙比利片安慰剂口服、肺炎球菌多价疫苗安慰剂注射+莫沙比利片安慰剂口服,每组接受为期1年的干预措施,观察各组患者下呼吸道感染发生及不良反应发生率。结果综合干预组、疫苗组、对照组下呼吸道感染率分别为3.1%、15.2%、16.7%,差异有统计学意义(P<0.05);3组不良反应发生率均较低,差异无统计学意义。结论肺炎球菌疫苗联合莫沙比利的综合性干预措施可以安全、有效地预防老年患者社区获得性下呼吸道感染。

OBJECTIVE To evaluate the efficacy and safety of a combined treatment with polyvalent pneumococcal vaccine（PPV） and mosapride for the prevention of community-acquired lower respiratory tract infections in the elderly so as to reduce the infection rate.METHODS A total of 210 elderly individuals with high risk to develop lower respiratory tract infections（LRTIs） were randomly divided into three groups,which were the PPV＋mosapride,PPV,and placebo,with 70 subjects in each group.In the PPV＋mosapride group,23-valent pneumococcal vaccine and mosapride were administered.In the PPV group,23-valent pneumococcal vaccine and placebo tablets were administered.In the PLACEBO group,the subjects received only placebo injections and tablets.A one-year treatment was required in each group.The occurrence of community-acquired LRTIs and the incidence rate of adverse reactions were observed.RESULTS The incidence rates of LRTIs were 3.1%,15.2% and 16.7% in the PPV＋mosapride,PPV,and placebo group,respectively,the difference was statistically significant（P0.05）.The incidence rates of the adverse reactions of the three groups were all relatively low,the difference was not statistically significant.CONCLUSION As a comprehensive intervention,the polyvalent pneumococcal vaccine combined with mosapride can effectively and safely prevent the community-acquired IRTIs in the elderly.