因果证据表明,疹疫苗可以预防一定比例的痴呆病例
Markus Eyting1,2,3, Min Xie1,2, Simon Heß4
1Division of Primary Care and Population Health, Department of Medicine, Stanford University; Stanford, CA 94305, USA.
medRxiv : the preprint server for health sciences
|June 9, 2023
概括
在一项为期七年的研究中,疹疫苗 (Zostavax) 显著减少了19.9%的痴呆症诊断. 这表明疹病毒可能在痴呆症的发展中发挥作用,突出了潜在的预防策略.
科学领域:
- 病毒学和神经学.
- 传染病流行病学 传染病流行病学
- 公共卫生干预措施 公共卫生干预措施
背景情况:
- 痴呆症的根本原因在很大程度上是未知的,有效的药物治疗有限.
- 对传染病原体,特别是疹病毒在痴呆症病因学中的潜在作用越来越感兴趣.
- 疹病毒 (Varicella zoster virus,简称VZV) 是一种导致带状疹的疹病毒,并与神经疾病有关.
研究的目的:
- 为了调查疹子感染和痴呆风险之间的因果关系.
- 评估疹疫苗 (Zostavax) 作为预防痴呆症的预防措施的潜力.
- 为了利用基于根据出生日期的疫苗资格进行因果推断的自然实验.
主要方法:
- 利用全国范围的威尔士疫苗接种,医疗服务和死亡证明数据.
- 采用基于1933年9月2日疹疫苗的资格截止值的自然随机化设计.
- 分析了符合条件和不符合条件的个体之间痴呆症诊断概率的差异,控制了混因素.
主要成果:
- 成功复制了疫苗在预防带状疹的已知有效性.
- 在接种疫苗的人群中,在七年内,新的痴呆症诊断的相对减少率为19.9% (绝对减少3.5个百分点).
- 与男性相比,在女性中观察到疫苗对痴呆症的更强的保护作用.
结论:
- 研究结果强烈表明疹病毒在痴呆症病因学中的因果作用.
- 疹疫苗显示出作为痴呆症预防干预措施的前景.
- 进一步的随机试验是有必要的,以优化疫苗的管理,以预防痴呆症.
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