流感疫苗接种与急性损伤的关联:一个潜在的目标试验仿真研究
Lin Zhuo1, Baixue Zhang2, Yi Huang3
1Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, People's Republic of China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, People's Republic of China.
概括
接种流感疫苗可显著降低17%的老年人急性损伤 (AKI) 的风险. 这项研究支持使用流感疫苗来预防老年人的脏并发症.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 免疫学 免疫学 免疫学
- 公共卫生 公共卫生
背景情况:
- 流感感染可能会导致全身损伤,包括功能障碍.
- 流感疫苗接种对急性损伤 (AKI) 风险的影响在大型前性研究中尚未得到充分证实.
- 老年人特别容易受到流感并发症的影响.
研究的目的:
- 评估流感疫苗接种与65岁及以上人群中AKI发病率之间的关联.
- 评估流感疫苗接种是否能提供对流感与脏相关并发症的保护.
主要方法:
- 在英国生物银行队列中使用顺序设计的目标试验模拟.
- 倾向性得分匹配 (1:1比) 用于比较65岁以上的接种疫苗和未接种疫苗的个人.
- 在1年的随访期内分析事件AKI,并对混因素进行调整.
主要成果:
- 接种流感疫苗与17%的AKI风险降低有关 (HR,0.83;95% CI,0.71-0.98).
- 与未接种疫苗的人相比,接种疫苗的人群中AKI的发病率较低 (30.6 / 10,000 PYs),而未接种疫苗的人群中 (36.8 / 10,000 PYs).
- 在接种疫苗的群体中也观察到死亡率显著降低 (HR,0.75;95% CI,0.66-0.85).
结论:
- 流感疫苗接种与老年人发生AKI的风险降低显著相关.
- 研究结果支持使用流感疫苗,以预防老年人流感及其相关的并发症.
- 进一步的研究应该解决潜在的残留混和选择偏差.
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