口服轮状病毒疫苗Rotarix保护效果的Meta分析

Meta analysis on protection effect of Rotarix oral rotavirus vaccine

目的评价口服轮状病毒疫苗Rotarix在全球范围内使用后对轮状病毒胃肠炎(RVGE)的保护效果,为Rotarix疫苗在全球轮状病毒高低死亡率地区的使用提供更好的科学依据。方法检索2001—2021年公开发表的符合入选标准的有关Rotarix疫苗的文献,共纳入了63990人研究对象,其中低死亡率地区纳入研究对象27725人,高死亡率地区纳入研究对象36265人,使用RevMan 5.3软件进行统计分析。结果在低死亡率地区,Rotarix对RVGE、SRVGE的保护率为VE_(RVGE)=73%(95%CI:58%~82%)、VE_(SRVGE)=89%(95%CI:80%~94%),其中对黄色人种RVGE、SRVGE保护效果为VE_(RVGE)=69%(95%CI:39%~84%)、VE_(SRVGE)=91%(95%CI:74%~97%),对白色人种RVGE、SRVGE保护效果为VE_(RVGE)=78%(95%CI:73%~83%)、VE_(SRVGE)=90%(95%CI:85%~93%);在高死亡率地区,Rotarix对RVGE、SRVGE的保护率为VE_(RVGE)=53%(95%CI:27%~70%)、VE_(SRVGE)=70%(95%CI:42%~85%),其中对黄色人种RVGE、SRVGE保护效果为VE_(RVGE)=61%(95%CI:45%~73%)、VE_(SRVGE)=80%(95%CI:68%~87%),对黑色人种RVGE、SRVGE保护效果为VE_(RVGE)=43%(95%CI:-98%~68%)、VE_(SRVGE)=42%(95%CI:25%~56%)。结论在任何地区口服Rotarix对预防任意严重程度轮状病毒胃肠炎都有一定的保护效果,对重症轮状病毒胃肠炎保护效果更好。在低死亡率地区,Rotarix对白色人种的任何严重程度轮状病毒胃肠炎的保护效果优于黄色人种;在高死亡率地区,Rotarix对黄色人种的任何严重程度轮状病毒胃肠炎的保护效果优于黑色人种。

Objective To evaluate the effect of Rotarix vaccine to prevent rotavirus gastroenteritis worldwide,and provide a better scientific basis for Rotarix vaccine use in regions with high and low rotavirus infection mortality.Methods A total of 63990 subjects were included in this analysis,including 27725 subjects in low-mortality region and 36265 subjects in high-mortality region.Software Revman 5.3 was used for statistical analysis.Results In low-mortality region,the protective rates of Rotarix vaccine against rotavirus gastroenteritis(VE_(RVGE))and severe rotavirus gastroenteritis(VE_(SRVGE))were 73%(95%CI:58%–82%)and 89%(95%CI:80%–94%),respectively,the protective rates against rotavirus gastroenteritis(VE_(RVGE))and severe rotavirus gastroenteritis in yellow race(VE_(SRVGE))were 69%(95%CI:39%–84%)and 91%(95%CI:74%–97%)and VE_(RVGE) and severe rotavirus gastroenteritis in white race(VE_(SRVGE))were 78%(95%CI:73%–83%)and 90%(95%CI:85%–93%).In high-mortality region,Rotarix vaccine’s VE_(RVGE) and severe rotavirus gastroenteritis(VE_(SRVGE))were 53%(95%CI:27%–70%)and 70%(95%CI:42%–85%),respectively,the VE_(RVGE) and severe rotavirus gastroenteritis(VE_(SRVGE))in yellow race were 61%(95%CI:45%–73%)and 80%(95%CI:68%–87%)and the VE_(RVGE) and severe rotavirus gastroenteritis(VE_(SRVGE))in black race were 43%(95%CI:-98%–68%)and 42%(95%CI:25%–56%)respectively.Conclusion Rotarix vaccine is safe and effective to prevent rotavirus gastroenteritis of any severity in any region,and has better protective effect against severe rotavirus gastroenteritis.Rotarix vaccine has better protective effect against rotavirus gastroenteritis of any severity in white race than in yellow race in low-mortality region.Rotarix vaccine is more effective in protecting from rotavirus gastroenteritis of any severity in yellow race than in black race in high-mortality region.