疫苗接种和类风湿性关节炎:对来自25949597名参与者的数据进行了更新的系统审查和元分析
Hejing Pan1, Yin Yu1, Xuanlin Li1
1School of Basic Medical Sciences of Zhejiang, Chinese Medical University, Binwen Road, Binjiang District, Hangzhou, China.
BMC public health
|March 11, 2025
概括
这项研究发现疫苗接种与类风湿性关节炎 (RA) 风险之间没有显著的联系. 然而,某些疫苗可能会在不到一年的随访期内对RA产生保护作用.
科学领域:
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
- 流行病学 流行病学
背景情况:
- 人们担心在接种疫苗后,风湿性关节炎 (RA) 的风险可能会增加.
- 系统性审查和元分析对于评估疫苗安全性及其与RA等自身免疫性疾病的关联至关重要.
研究的目的:
- 系统地审查和元分析各种疫苗接种与患类风湿性关节炎 (RA) 的风险之间的关联.
- 为了解决有关疫苗对RA发展的潜在不良影响的公共卫生问题.
主要方法:
- 在主要数据库 (PubMed,EMBASE,Cochrane Library) 进行了对队列和病例控制研究的全面系统搜索,直到2024年9月.
- 用纽卡斯尔-太华尺度评估偏差风险,用GRADE系统评估证据确定性.
- 随机效应元分析对疫苗接种和RA相关性进行了相对风险 (RR) 和95%置信区间 (CI).
主要成果:
- 分析包括16项涉及2500多万参与者的研究,发现整体疫苗接种与RA风险之间没有显著联系 (RR=1.03,95% CI [0.95-1.11]).
- 对HPV,流感,炭,疹和COVID-19疫苗的亚组分析也显示没有显著的RA风险.
- 在随访时间<1.8年 (RR=0.92,95% CI [0.87-0.98]) 的小组中观察到 (HPV和COVID-19) 疫苗对RA的保护作用.
结论:
- 目前的证据不足以确定疫苗接种与风湿性关节炎风险增加之间的明确联系.
- 接种疫苗,特别是HPV和COVID-19疫苗,可能在短期内 (随访期<1年) 提供对RA的保护作用.
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