2014-2015年中国40岁及以上慢性阻塞性肺疾病患者肺炎疫苗接种状况

Pneumococcal vaccination rate in chronic obstructive pulmonary disease patients aged 40 years or older in China,2014-2015

目的了解我国≥40岁慢性阻塞性肺疾病(慢阻肺)患者的肺炎疫苗接种状况,为慢阻肺的防控提供科学依据。方法将2014-2015年中国居民慢性阻塞性肺疾病监测中支气管舒张试验后测试FEV1/FVC<70%的调查对象作为慢阻肺患者,其中9067名通过询问调查明确肺炎疫苗接种情况的患者被纳入本研究分析。应用复杂抽样调整方法,估计慢阻肺患者中的肺炎疫苗接种率及其95%CI,并对其影响因素进行分析。结果我国≥40岁慢阻肺患者的5年内肺炎疫苗接种率是0.8%(95%CI:0.3%~1.4%)。40~岁组患者的肺炎疫苗接种率是0.3%(95%CI:0.2%~0.5%),≥60岁组患者的接种率为1.2%(95%CI:0.3%~2.1%)(P<0.05);城镇患者的接种率(1.5%)高于乡村患者(0.4%)(P<0.05);慢阻肺患者的气流受限程度越严重,其肺炎疫苗接种率越高(P<0.05);合并其他慢性肺部疾病或糖尿病的患者接种率为1.7%、2.1%,高于未合并的患者(P<0.05);曾经吸烟的慢阻肺患者肺炎疫苗接种率为1.4%,现在吸烟的患者接种率为0.6%。慢阻肺患者的肺炎疫苗接种与年龄、文化程度、职业、气流受限严重程度分级、流感疫苗接种史有关。结论我国≥40岁慢阻肺患者的肺炎疫苗接种率非常低,需要采取多种措施加强对慢阻肺患者的健康教育与肺炎疫苗接种推荐。

Objective To understand the pneumococcal vaccination rate in chronic obstructive pulmonary disease(COPD)patients aged 40 years or older in China and provide evidence for COPD control and prevention.Methods COPD patients with post-bronchodilator FEV1/FVC<70%in COPD surveillance(2014-2015)of China were used as study subjects,in which 9067 patients with definite pneumococcal vaccination status were included.The pneumococcal vaccination rate and its 95%CI in COPD patients were estimated using data adjusted by complicated sampling method.The factors in association with the vaccination rate were also identified.Results The pneumococcal vaccination rate was 0.8%in the past five years in COPD patients aged 40 years or older in China(95%CI:0.3%-1.4%).The vaccination rate was 0.3%in the patients aged 40 to 59 years(95%CI:0.2%-0.5%)and 1.2%in the patients aged 60 years or older(95%CI:0.3%-2.1%)(P<0.05).The rate was higher in the patients living in urban area(1.5%)than in those living in rural area(0.4%)(P<0.05).The vaccination rate increased with the severity of airflow limitation(P<0.05).The patients with comorbidities of other chronic lung diseases or diabetes had higher vaccination rate(1.7%and 2.1%)compared with those without comorbidities(P<0.05).The vaccination rate was 1.4%in former smokers and 0.6%in current smokers.The pneumococcal vaccination rate in COPD patients was associated with age,education level,occupation,the severity of airflow limitation and the history of influenza vaccination.Conclusions The pneumococcal vaccination rate was extremely low in COPD patients aged 40 years or older in China.It is necessary to strengthen the health education and recommendation for pneumococcal vaccination in COPD patients through different measures.