探討流感疫苗對於慢性阻塞性肺部疾病病人併發缺血性心臟疾病之影響

郭碧蓮

doi:10.6831/TMU.2012.00238

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探討流感疫苗對於慢性阻塞性肺部疾病病人併發缺血性心臟疾病之影響

Investigation of Outcomes of annual influenza vaccination on chronic obstruction pulmonary disease patients comorbid with ischemic heart disease

郭碧蓮 , Masters　　Advisor：簡文山　　

繁體中文 DOI： 10.6831/TMU.2012.00238

流感疫苗；慢性阻塞性肺部疾病；缺血性心臟疾病；全民健保資料庫； Influenza vaccine ； Chronic obstruction pulmonary disease ； Ischemic heart disease ； National Health Insurance research database

Abstract │ Reference (27) │ Altmetrics

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Background：Chronic obstruction pulmonary disease (COPD) is within the top 10 leading causes of death in Taiwan many years, and the prevalence rate has reached 6.7%. WHO estimate COPD is the fourth leading cause of death and is projected to be the third by 2020 although the disease is both preventable and treatable. So how to reduce its complications becomes one of the key of treatment. The ischemic heart disease (IHD) is the most common comorbidity of COPD, therefore to find an intervention which can reduce heart diseases in COPD patients is an important issue.

Purpose：The purpose of this study was to investigate the effect of influenza vaccine on comorbidity of ischemic heart disease with COPD.

Methods：This was a study by using “National Health Insurance research database” between 1997 and 2008. The subjects were included the first diagnosed with COPD but without ischemic heart diseases in 2000. These subjects were followed until the ischemic heart disease occurred and traced back to check if they were vaccinated. The descriptive statistics were used to analyze the distributions of variables and 2-way Contingency Table Analysis with Chi-Square test (  test) was used to explore the effect of influenza vaccine on comorbidity of ischemic heart disease with COPD.

Results：Among 35,897 first diagnosed COPD subjects in 2000, there were 1,464 patients developed ischemic heart disease (IHD) between 2001 and 2008. 703 (48.02%) out of COPD patients with comorbidity of IHD were vaccinated, but only 6010 patients (22.9%) were vaccinated without develop IHD. Comparing vaccination rate of male to female with COPD was 1.5 to 1, and of COPD with IHD patients was 1.2 to 1. Under statistically control age and gender factors, vaccination was associated with reduced risk of IHD in elderly COPD patients who were in 71-80 years old group (OR, 0.746; 95% CI. 0.595–0.937 ).

Conclusions：The findings of this study showed that the vaccination rate of COPD patients with ischemic heart diseases were higher than those without IHD. Influenza vaccination was associated with reduced risk of IHD in COPD patients only on the elderly group. If the severity and comorbidities of the COPD can be further understood, it will provide more comprehensive information for these patients and improve their disease management.

Reference ( 27 ) 〈TOP〉

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連結：
Calverley, P. M., Anderson, J. A., Celli, B., Ferguson, G. T., Jenkins, C., Jones, P. W., . . . Vestbo, J. (2007). Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med, 356(8), 775-789. doi: 10.1056/NEJMoa063070
連結：
Cazzola, M., Bettoncelli, G., Sessa, E., Cricelli, C., & Biscione, G. (2010). Prevalence of comorbidities in patients with chronic obstructive pulmonary disease. Respiration, 80(2), 112-119. doi: 10.1159/000281880
連結：
de Diego, C., Vila-Corcoles, A., Ochoa, O., Rodriguez-Blanco, T., Salsench, E., Hospital, I., . . . Canals, M. (2009). Effects of annual influenza vaccination on winter mortality in elderly people with chronic heart disease. Eur Heart J, 30(2), 209-216. doi: 10.1093/eurheartj/ehn498
連結：
Gorse, G. J., O'Connor T, Z., Young, S. L., Habib, M. P., Wittes, J., Neuzil, K. M., & Nichol, K. L. (2006). Impact of a winter respiratory virus season on patients with COPD and association with influenza vaccination . Chest, 130(4), 1109-1116. doi: 10.1378/chest.130.4.1109
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