2020年河南省≥40岁慢性阻塞性肺疾病患者流感和肺炎球菌疫苗接种情况及影响因素分析

Analysis on the status of influenza and pneumococcal vaccination and its influencing factors among the residents aged≥40 years with chronic obstructive pulmonary disease in Henan,2020

目的了解2020年河南省≥40岁慢性阻塞性肺疾病(慢阻肺,COPD)患者流感疫苗和肺炎球菌疫苗接种情况,分析影响接种的因素,为采取积极有效的个性化防控措施提供依据。方法从河南省居民慢性阻塞性肺疾病监测信息收集与管理平台,用随机分层整群抽样法,筛查出2020年符合支气管舒张试验后肺功能测试FEV_(1)/FVC<70%的≥40岁慢阻肺患者。通过问卷调查,了解慢阻肺患者流感疫苗和肺炎球菌疫苗接种情况及影响因素。结果2020年河南省≥40岁居民调查有效人数为10222人,筛查出慢阻肺患者952人。经复杂加权后,慢阻肺患病率为9.17%,慢阻肺患者流感疫苗和(或)肺炎球菌疫苗总接种率为4.29%,流感疫苗接种率为3.63%,肺炎球菌疫苗接种率为1.41%,流感疫苗和肺炎球菌疫苗联合接种率为0.75%。年龄40~<60岁、高中以下文化程度、无呼吸道疾病史、有吸烟史、肺功能Ⅱ级以下的慢阻肺患者接种率较低(P均<0.05)。其中,年龄≥60岁(OR=2.758,95%CI:1.180~6.444)、有呼吸道疾病史(包括肺癌)(OR=2.391,95%CI:1.144~4.996)是慢阻肺患者流感疫苗和肺炎球菌疫苗接种的促进因素,有吸烟史(OR=0.491,95%CI:0.247~0.975)是疫苗接种的阻碍因素。结论河南省≥40岁慢阻肺患者流感疫苗和肺炎球菌疫苗接种率较低,应积极采取加强宣传和健康教育、降低疫苗价格、提高疫苗推介力度等措施提高疫苗接种率。

Objective To understand the status of influenza and pneumococcal vaccination among the residents aged 40 years and over with chronic obstructive pulmonary disease(COPD)in Henan province in 2020,analyze the factors affecting the vaccination,and provide basis for taking active and effective personalized prevention and control measures.Methods Based on Henan province Residents′Chronic Obstructive Pulmonary Disease Monitoring Information Collection and Management Platform,a randomized stratified cluster sampling method was used to screen out the residents aged 40 years and over with COPD and FEV_(1)/FVC<70%after bronchodilation test in 2020.The status and influencing factors of influenza and pneumococcal vaccination among the residents with COPD were explored through a questionnaire survey.Results The number of eligible 2020 survey residents aged 40 and over in Henan province was 10222,and 952 were screened for COPD.After complex weighting,the incidence rate of COPD was 9.17%.The overall rate of influenza or pneumococcal vaccination for residents with COPD was 4.29%;the rate of influenza vaccination was 3.63%;the rate of pneumococcal vaccination was 1.41%;and the rate of influenza and pneumococcal combined vaccination was 0.75%.Residents with COPD aged 40-<60 years,having high school education,no history of respiratory diseases(including lung cancer),having smoking history,and having lung function below grade II had lower vaccination rates(all P<0.05).Among them,the residents aged 60 years and over(OR=2.758,95%CI:1.180-6.444)and having a history of respiratory diseases(including lung cancer)(OR=2.391,95%CI:1.144-4.996)increased the likelihood of vaccination for COPD,while those with smoking history of(OR=0.491,95%CI:0.247-0.975)decreased the likelihood of vaccination for COPD.Conclusions The rates of influenza and pneumococcal vaccination among the residents with COPD and aged 40 years and over in Henan province are relatively low;the measures should be actively taken,such as strengthening the publicity and health education,reducing the price of vaccine,improving the efforts to promote the vaccination and so on,for improving the vaccination rate.