肺炎球菌多糖结合疫苗不同免疫程序的免疫学效果Meta分析

The Meta-Analysis of Immunological Effects of Pneumococcal Polysaccharide Conjugate Vaccine Following Different Immunization Schedules

目的评价肺炎球菌多糖结合疫苗(Pneumococcal Polysaccharide Conjugate Vaccine,PPCV)按照不同免疫程序接种后的免疫学效果。方法电子检索National Center for Biotechnology Information(NCBI,《美国国家医学图书馆数据库》)、《考克兰(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》、《万方全文数据库》等数据库,将有关接种PPCV免疫学效果的研究纳入分析。使用综述管理(RevMan)5.1软件进行统计分析,按照不同免疫程序接种完成最后1剂PPCV后的抗体水平[抗体浓度≥0.35微克/毫升(μg/ml)判定为阳性],计算抗体阳转率(Antibody Positive Rate,APR)的率差(Rate Different,RD)。结果共纳入6篇文献,均为随机对照试验。2剂基础免疫(2 Primary Doses,2p)程序与3剂基础免疫(3 Primary Doses,3p)程序之间APR的合并RD是-0.08[95%可信区间(Confidence Interval,CI):-0.10^-0.05]。2剂基础免疫+1剂加强免疫(2 Primary Doses+1 Booster Dose,2p+1)与3剂基础免疫+1剂加强免疫(3 Primary Doses+1 Booster Dose,3p+1)程序之间APR合并的RD是-0.02(95%CI:-0.03^-0.01)。结论 3p免疫程序免疫学效果优于2p免疫程序,2p+1和3p+1免疫程序的免疫学效果并无明显差异。

Objective To evaluate the immunological effects of pneumococcal polysaccharide conjugate vaccine （PPCV） following different immunization schedules. Methods Relevant studies of immunological effects of PPCV were searched from the following databases ： ＂National Center for Biotechnology Information＂,＂Cochrane Library＂,＂ China Biology Medicine disc＂,＂ China National Knowledge Infrastructure＂ and ＂Wanfang Database＂ etc. The Rate Difference （RD） of the antibody positive rate （APR） was calculated according to the antibody level （with seropositivity defined as an antibody concentration ≥ 0. 35 μg） following the last dose of PPCV following different immunization schedules. Results A total of 6 randomized controlled trials （RCT） were included. Combined RD of APR between a 2 primary dose schedule and a 3 primary doses schedule was -0. 08 [95% confidence interval （CI）：-0. 10～-0. 05]. Combined RD Of APR between a 2 primary doses ＋ 1 booster dose （2p ＋ 1 ） schedule and a 3 primary doses ＋1 booster dose（3p＋1） schedule was -0.02 （95%CI：-0.03 ～-0.01）. Conclusions The immunological effect of a 3p schedule was better than a 2p schedule. There was no statistically significant difference in the immunological effects between 2p ＋ 1 and 3p ＋ 1 schedules.