7岁以下儿童接种1剂次或2剂次Salk-IPV免疫效果的Meta分析

A meta-analysis on immunogenicity of one dose or two dose salk strain inactivated poliovirus vaccine among children under seven years

目的 评价7岁以下儿童接种1剂次或2剂次Salk株脊髓灰质炎灭活疫苗（Salk-IPV）的免疫效果,为实施灭活脊髓灰质炎疫苗（IPV）序贯免疫时制定相应的免疫程序提供参考。方法 通过检索美国国家医学图书馆数据库（NCBI）、Cochrane协作网图书馆、中国生物医学文献数据库（CBMdisc）、知网数据库（CNKI）和万方数据库,将评价Salk-IPV免疫效果的研究纳入分析。以〈7岁儿童接种疫苗至少1个月后诱导中和抗体的血清阳转率（SR）作为观察指标进行Meta分析;描述接种不同剂次Salk-IPV接种后血清型脊髓灰质炎中和抗体的SR的变化趋势。结果 共纳入11篇文献,Meta分析结果显示：接种1剂次Salk-IPV后,I、Ⅱ和Ⅲ型脊髓灰质炎病毒中和抗体的SR分别为29%（95%CI：19%-39%）、41%（95%CI：31%-51%）和38%（95%CI：28%-48%）;接种2剂次Salk-IPV后,I、Ⅱ和Ⅲ型脊髓灰质炎病毒中和抗体的SR分别为82%（95%CI：74%-90%）、83%（95%CI：77%-88%）和91%（95%CI：87%-95%）。随着免疫起始月龄推后,无论接种1剂次还是2剂次Salk-IPV,不同血清型脊髓灰质炎病毒中和抗体的SR均呈上升趋势。结论 7岁以下儿童采用二价口服脊髓灰质炎减毒活疫苗和Salk-IPV序贯免疫策略时,建议在常规免疫中至少接种2剂次以上Salk-IPV疫苗,血清中和抗体才有较高的阳性率。

Objective To evaluate immunogenicity of one dose or two dose salk strain inactivated poliovirus vaccine （ Salk - IPV ） among children under seven years . Methods Searching ＂ National Center for Biotechnology Information , NCBI ＂ , ＂Cochrane Library ＂ ＂ China Biology Medicine disc , CBMd ＂,＂ China National Knowledge Infrastructure , CNKI ＂, ＂Wanfang Database, WF’’,studies for assessing immunogenicity of Salk - IPV were included. The seroconversion rate （SR） of neutralization antibody （ NA） of specific type of polio vims with an interval of one month after vaccination was used as our endpoints. Pooled SR with 95% Confidence Interval （CI） was calculated by RevMan5. 1 software. The association between seroconversion and age at administration was described by R 3. 2. 2 program. Results A total of 11 studies were included. One dose of Salk - IPV seroconvert 29% （95%C/： 19% - 39% ） ,41% （95% C/： 31% -5 1% ） and 38% （95% C/： 28% -48% ） of infants aged 7 years against serotypes I, II ,and HI on average,while 2 doses seroconvert 82% （95% CI： 74% - 90% ）, 83% （95% C/： 77% - 88% ） and 91% （ 95% C/： 87% - 95% ） , respectively. Seroconversion increased with the starting age for both one dose and two dose schedules. Conclusion Routine immunization with at least 2 doses of Salk - IPV was recommended as a sequential schedule with two - valent oral polio vims vaccine and Salk - IPV was applied.