系统性红斑狼疮患者疫苗接种及影响因素的现况调查

The investigation of vaccination ipus erythematosus

目的了解SLE患者接种流感病毒疫苗、肺炎球菌疫苗、乙型肝炎病毒(HBV)疫苗、人乳头状瘤病毒(HPV)疫苗、水痘-带状疱疹(VZV)病毒疫苗情况, 分析影响患者疫苗接种的相关因素。方法采用网络问卷横断面调查的研究方法, 2021年5月至8月调查17个风湿病中心, 1 203例SLE患者, 记录患者一般社会学人口学资料、患病治疗情况、疫苗接种意愿、近5年内疫苗接种情况。一般资料采用描述分析, 患者接种疫苗的影响因素的相关性分析采用χ^(2)检验及Logistic回归分析。结果在1 203例SLE患者中, 疫苗接种率分别为流感病毒疫苗5.49%(66/1 203)、肺炎球菌疫苗0.66%(8/1 203)、HPV疫苗3.82%(46/1 203)、HBV疫苗2.08%(25/1 203)以及VZV疫苗0.17%(2/1 203)。大学及本科以上学历(χ^(2)=30.94, P<0.001)、家庭年收入≥8万(χ^(2)=10.70, P=0.001)的患者接种流感病毒疫苗的比例更多;大学本科及以上学历(χ^(2)=20.96, P<0.001)、家庭年收入≥8万(χ^(2)=20.56, P<0.001)、<45岁(χ^(2)=8.54, P=0.001)以及未婚(χ^(2)=5.63, P=0.018)患者接种HPV疫苗比例更高;男性(χ^(2)=10.27, P=0.001)及大学本科及以上学历(χ^(2)=4.52, P=0.034)患者接种HBV疫苗比例更高。Logistic回归分析结果显示:对于流感病毒疫苗, 大学本科及以上学历[OR(95%CI)=6.01(3.09, 11.68), P=0.001)]、有低于18岁孩子[OR(95%CI)=1.80(1.02, 3.18), P=0.042)、应用羟氯喹[OR(95%CI)=2.14(1.10, 4.18), P=0.026)]为影响因素;男性患者[OR(95%CI)=4.24(1.37, 13.08), P=0.012)]以及大学本科及以上学历[OR(95%CI)=2.55(1.06, 6.15), P=0.037)]患者更多接种HBV疫苗;接种HPV疫苗的影响因素为年龄<45岁[OR(95%CI)=0.93(0.89, 0.97), P=0.001)]、大学本科及以上学历[OR(95%CI)=2.28(1.11, 4.65), P=0.024)]、家庭年收入≥8万[OR(95%CI)=2.675(1.32, 5.41), P=0.006)]以及应用免疫抑制剂[OR(95%CI)=1.92(1.03, 3.59), P=0.041)]。结论 SLE患者疫苗接种率普遍较低, 高收入、高学历患者接种疫苗比例明显增加, 风湿科医师及卫生行政部门专业人员应重视SLE患者疫苗接种健康宣教, 降低相关感染的发生率。

Objective To investigate the prevalence of influenza,pneumococcal,hepatitis B virus(HBV),human papillomavirus((HPV),and varicella zoster virus(VZV)vaccination in patients with systemic lupus erythematosus(SLE),and to analyze the factors related to vaccination.Methods Data were obtained from 1203 patients with SLE,via a multi-center web-based survey using an online questionnaire.Data about their social conditions,clinical presentations,willingness for being vaccinated,vaccination within 5 years were collected.Demographic data were shown by descriptive analysis.Chi-square and logistic regression analysis were used to assess the power of related indexes as predictors of vaccination.Results The vaccination rates of influenza,pneumococcal,HBV,HPV,and VZV were 5.49%(66/1203),0.66%(8/1203),2.08%(25/1203),3.82%(46/1203),and 0.17%(2/1203),respectively.Data analysis showed that higher education(χ^(2)=30.94,P<0.001)and higher income(χ^(2)=10.70,P=0.001)had greater effects on influenza vaccination.There was a relationship between HPV vaccination and higher education(χ^(2)=20.96,P<0.001),higher income(χ^(2)=20.56,P<0.001),younger age(2=8.54,P=0.001),and single(χ^(2)=5.63,P=0.018).Male(χ^(2)=10.27,P=0.001)and higher education(2=4.52,P=0.034)were associated with HBV vaccination.The multivariate logistic regression analysis revealed that higher education[OR(95%CI)=2.14(1.10,4.18),P=0.026],having children under 18 years-old[OR(95%CI)=1.802(1.02,3.18),P=0.042],and hydroxychloroquine usage[OR(95%C)=2.55(1.06,6.15),P=0.037],had a positive correlation with influenza vaccination.Male[OR(95%CI)=4.24(1.37,13.08),P=0.012],had an impact on HBV vaccination.The factors related to HPV vaccination included age<45[OR(95%CI)=0.93(0.89,0.97),P=0.001],higher education[OR(95%CI)=2.28(1.11,4.65),P=0.024],higher income[OR(95%CI)=2.68(1.32,3.41),P=0.006]and the usage of immunosuppressive agents[OR(95%CI)=1.92(1.03,3.59),P=0.041 J.Conclusion The prevalence of vaccination in patients with SLE is low.Patients with higher education and income are more likely to being vaccinated.