口服人-牛(WC_3株)5价轮状病毒基因重配活疫苗保护效果的Meta分析

Meta-analysis of protective efficacy of oral pentavalent human-bovine reassortant rotavirus live-attenuated vaccine

目的评价口服人-牛(WC_3株)5价轮状病毒基因重配活疫苗(PRV)的保护效果。方法检索中国生物医学文献数据库等中文数据库和美国国家医学图书馆数据库等外文数据库,检索有关PRV保护效果的研究纳入分析。按照研究地区的社会经济发展水平、疫苗株和流行株的匹配情况,分别合并试验组和对照组针对不同型别轮状病毒感染引起的急性肠炎发病的相对危险度(RR)或比值比(OR),计算疫苗效力(VE)。结果共纳入5篇病例对照研究。高发展水平国家,在疫苗株和流行株完全匹配的情况下,VE=94%(95%CI:84%~98%);在疫苗株和流行株不完全匹配的情况下,VE=82%(95%CI:70%~89%);在单一抗原匹配的情况下,VE=82%(95%CI:70%~89%);在单一抗原不匹配的情况下,VE=75%(95%CI:47%~88%)。中等发展水平国家,在疫苗株和流行株不完全匹配的情况下,VE=37%(95%CI:10%~56%);在单一抗原匹配的情况下,VE=71%(95%CI:60%~78%);在单一抗原不匹配的情况下,VE=76%(95%CI:61%~85%)。结论接种PRV可降低轮状病毒感染引起的急性肠炎发病率,PRV的保护效果与疫苗株和流行株匹配情况以及地区因素有关。

Objective To evaluate the protective efficacy（VE） of oral pentavalent human-bovine reassortant rotavirus live-attenuated vaccine（PRV）. Methods We searched China Biology Medicine disc, China National Knowledge Infrastructure,Wanfang Database, National Center for Biotechnology Information and Cochrane Library about VE of PRV. Pooled estimates of odds ratio（OR） or relative risk（RR） of the incidence rates of rotavirus gastroenteritis and the vaccine efficacy（VE） were calculated according to the socio-economic development level and match of vaccine strains with pandemic strains,specifically.Results Five studies were included. In the highly developed countries,VE was 94%（95%CI：84%-98%） against homotypic strains, 82%（95% CI： 70%-89%） against partly heterotypic strains, 82%（95% CI： 70%-89%） against single-antigen vaccine type strains,and 75%（95%CI：47%-88%） against single-antigen non-vaccine type strains. In the middle developed countries, VE was 37%（95% CI： 10%-56%） against partly heterotypic strains, 71%（95% CI： 60%-78%） against single-antigen vaccine type strains, and 76%（95% CI： 61%-85%） against single-antigen non-vaccine type strains.Conclusion PRV can reduce the incidence of rotavirus gastroenteritis. The VE of PRV is related to the socio-economic development level and match of vaccine strains with pandemic strains.