脊髓灰质炎灭活疫苗和减毒活疫苗免疫原性与安全性的Meta分析

Meta Analysis of Protective Efficacy of Safety of Inactivated Poliovirus Vaccine and Oral Poliovirus Vaccine

目的比较脊髓灰质炎灭活疫苗和减毒活疫苗的免疫原性与安全性的差异。方法检索美国国家医学图书馆数据库（NCBI），Cochrane协作网图书馆（CL）、中国期刊网全文数据库（CNKI）、万方医学网等数据库中检索，收集接种脊髓灰质炎灭活疫苗和减毒活疫苗的免疫原性与安全性的随机对照研究，提取资料和评估方法学质量，采用Review Manager5．0软件对2种疫苗的保护效果及安全性进行Meta分析，二分类变量用相对危险度（RR）和95％可信区间CI（95％）表达，连续变量用标准均数差（SMD）及其95％CI表达。结果纳入6项随机对照研究。在不考虑脊髓灰质炎疫苗接种总剂次数的前提下，Meta分析显示，IPV接种组较OPV接种组可以提高幼儿脊髓灰质炎TypeⅢ型保护效果为[RR合并=1．16，95％CI：1．12—1．20），P〈0．01]，但疫苗的安全性[RR合并=1．03，95％C1：0．88，1．20），P〉0．05]差异无统计学意义。结论脊髓灰质炎灭活疫苗针对脊髓灰质炎病毒TypeⅢ具有较好保护效果。

Objective To evaluate vaccine protective efficacy of inactivated poliovirus vaccine and oral poliovirus vaccine. Methods Databases were retrieved including NCBI, CL, PUBMED, CNKI and WANFANG. The randomization, concealment of allocation and blinding were included in the study. Results A total of 6 studies were included, all of which were random clinical trials. The protective efficacy was related to the titer of vaccine （ IPV or OPV）. The VE of IPV against invasive poliomyelitis type Ⅲ was [RR =- 1.16, 95% CI： 1.12 - 1.20 ; P〈0.01]. While the safety of the vaccine showed no statistical difference [RR = 1.03, 95% CI： 0. 88 - 1.20, P 〉 0. 05]. Conclusion The protective efficacy of inactivated poliovirus vaccine is better than oral poliovirus vaccine.