四价流感病毒灭活疫苗在18~64岁人群免疫原性和安全性的系统综述和Meta分析

目的 用Meta分析的方法评价四价流感病毒灭活疫苗在18~64岁人群的免疫原性（抗体保护率和抗体阳转率）。方法 检索Medline、Cochrane Library、Science Direct数据库，将近10年内发表的比较18~64岁人群接种四价流感病毒灭活疫苗和三价流感病毒灭活疫苗免疫原性的临床随机对照试验纳入分析。采用Revman 5.3软件对纳入文献数据进行Meta分析。结果 共纳入8篇文献，针对甲型流感株（A/H1N1、A/H3N2）的抗体保护率和抗体阳转率，两种疫苗的反应差异无统计学意义；针对不含乙型流感株B/Victoria的三价流感病毒灭活疫苗，四价流感病毒灭活疫苗抗体保护率的合并RR值为1.28（95% CI：1.08~1.51，P<0.05），抗体阳转率的合并RR值为1.94（95% CI：1.50~2.50，P<0.05）；针对不含乙型流感株B/Yamagata的三价流感病毒灭活疫苗，四价流感病毒疫苗抗体保护率的合并RR值为1.10（95% CI：1.02~1.18，P<0.05），抗体阳转率的合并RR值为1.99（95% CI：1.34~2.97，P<0.05），差异有统计学意义。结论 18~64岁人群中，四价流感病毒灭活疫苗与三价流感病毒灭活疫苗对于相同的疫苗株产生的免疫原性无差异，对于三价流感病毒灭活疫苗中不含的乙型疫苗株能产生良好的免疫效果。

Immunogenicity of inacitivated quadrivalent influenza vaccine in adults aged 18-64 years: A systematic review and Meta-analysis

Objective To evaluate the immunogenicity of inactivated quadrivalent influenza vaccine (QIV) in adults aged 18-64 years, through a Meta-analysis. Methods Literature was retrieved by searching the Medline, Cochrane Library, Science Direct in the past decade. All the studies were under random control trial (RCT) and including data related to immunogenicity which involving sero-protection rate (SPR) and sero-conversion rate (SCR) of the QIV, versus inactivated trivalent influenza vaccine (TIV) in the population aged 18 to 64. Revman 5.3 software was employed to manipulate the pooled date of the included literature. Result A total of 8 studies for the SPR and SCR of the shared strains (two A lineage and one B lineage) were included. There appeared no significant differences in the response rates between the two vaccines. As for QIV versus TIV (B/Yamagata), the pooled RR of the SPR for B/Victoria was 1.28 (95% CI:1.08-1.51, P<0.05), with the pooled RR of the SCR for B/Victoria as 1.94 (95% CI:1.50-2.50, P<0.05). For QIV versus TIV (B/Victoria), the pooled RR of the SPR for B/Yamagata as 1.10 (95% CI:1.02-1.18, P<0.05), and the pooled RR of SCR for B/Yamagata as 1.99 (95% CI:1.34-2.97, P<0.05). Conclusion In the population aged 18-64 years, inactivated QIV was equivalently immunogenic against the shared three strains included in the activated TIV while a superior immunogenic effect was noticed in the vaccine strain which did not include the inactivated QIV.