中国1978年后出生健康人群破伤风抗体保护率Meta分析

Meta?analysis on tetanus antibody protection rate of healthy population born after 1978 in China

目的对中国1978年后出生的健康人群破伤风抗体保护率进行Meta分析。方法检索中国知网、万方数据知识服务平台、维普期刊资源整合服务平台、中国生物医学文献服务系统、PubMed英文数据库和The Cochrane Library中公开发表的中国(不含中国香港、澳门和台湾数据)破伤风抗体水平的研究文献,中文检索主题词为“破伤风抗毒素”“破伤风抗体”“健康人群”“中国内地”,英文检索词包括“tetanus antitoxin”“tetanus vaccine”“tetanus vaccination”“general population”“mainland of china”,纳入文献研究时限为2010—2019年,采用Stata软件对破伤风抗体保护率进行Meta分析。结果共纳入24篇文献,总调查人数为23530名,抗体保护率为49.5%~99.0%。抗体≥0.1 IU/ml为达到保护水平,共20817名,破伤风抗体合并保护率为78.6%(95%CI:75.0%~88.2%)。0~7和8~15岁组抗体合并保护率分别是88.9%(95%CI:86.9%~91.0%)和79.3%(95%CI:72.9%~86.2%);16~20、21~30和31~40岁组抗体合并保护率分别为58.9%(95%CI:46.5%~71.2%)、47.7%(95%CI:16.8%~78.7%)和63.8%(95%CI:32.6%~95.1%);0~15岁组破伤风抗体的合并保护率为85.6%(95%CI:83.1%~88.1%),16~40岁组抗体的合并保护率为52.9%(95%CI:39.3%~66.6%)。结论随着年龄增长,我国16~40岁健康人群破伤风抗体保护率下降,应根据既往破伤风疫苗接种史,必要时根据破伤风抗体水平,制定个体化的疫苗接种方案。

Objective Meta analysis was conducted on the tetanus antibody protection rate of healthy population born after 1978 in China(data from Hong Kong,Macao and Taiwan was excluded,the same below).Methods Search the data on China′s tetanus antibody level which were published in China National Knowledge Infrastructure,Wanfang data,VIP,SinoMed database,PubMed and the Cochrane Library.The Chinese search keywords were"Tetanus Antitoxin","Tetanus Antibody","Healthy Population"and"China's Mainland".English search terms include"tetanus antitoxin","tetanus vaccine","tetanus vaccine","general population"and"mainland of China".The time limit for inclusion in literature research was 2010-2019.Stata software was used to conduct meta analysis on the protection rate of tetanus antibody.Results A total of 24 articles were included.There was no obvious publication bias in the included articles.The total number of respondents was 23530,the antibody protection rate was 49.5%-99.0%.A total of 20817 people got effective antibody protection,which meant the antibody level reached and exceeded 0.1 IU/ml,and the combined protection rate was 78.6%(95%CI:75.0%-88.2%).The combined protection rates of antibody in 0-7 years old and 8-15 years old groups were 88.9%(95%CI:86.9%-91.0%)and 79.3%(95%CI:72.9%-86.2%)respectively.The combined protection rates of antibodies in 16-20 years old,21-30 years old and 31-40 years old groups were 58.9%(95%CI:46.5%-71.2%),47.7%(95%CI:16.8%-78.7%)and 63.8%(95%CI:32.6%-95.1%)respectively.The combined protection rate of tetanus antibody for 0-15 years old people was 85.6%(95%CI:83.1%-88.1%),and the combined protection rate of antibody for 16-40 years old people was 52.9%(95%CI:39.3%-66.6%).Conclusion With the increase of age,the protection rate of tetanus antibody among the healthy population aged 16-40 years in our country decreases.An individualized vaccination plan should be formulated according to the previous tetanus vaccination history and the tetanus antibody level when necessary.