目的 了解慢性阻塞性肺疾病(COPD)患者联合接种23价肺炎球菌多糖疫苗(PPV23)和流感病毒裂解疫苗(流感疫苗)安全性。方法 选择近一年在东阳市人民医院住院过的COPD患者,经预检无接种禁忌症者同时在左、右臂分别接种PPV23和流感疫苗,于接种后30 min、3 d、30 d进行主动观察不良反应发生率、不良反应类型和严重程度。结果 共观察644例,发生不良反应174例,不良反应发生率为27.02%,其中一般反应172例,偶合反应2例。172例一般反应中局部反应132例,全身反应37例,局部反应和全身反应同时发生3例;PPV23和流感疫苗的局部反应发生率分别为16.46%(106/644)和13.51%(87/644),差异无统计学意义(χ²=2.200,P=0.140),局部反应主要为接种部位的疼痛和红肿,全身反应以发热、疲倦乏力和食欲下降为主,所有患者均在一周内恢复。结论 COPD患者联合接种PPV23和流感疫苗具有较高的安全性。

Objective To investigate the safety of patients with chronic obstructive pulmonary disease (COPD) vaccinated with 23 valent pneumococcal polysaccharide vaccine (PPV23) and influenza vaccine (split virion) at the same time. Methods COPD patients who had been hospitalized in Dongyang People's Hospital in recent one year were selected.Those who had been pre-examined and had no contraindications for vaccination were simultaneously vaccinated with PPV23 and influenza vaccines on their left and right arms,and actively observed the incidence,type and severity of adverse reactions at 30min,3d,and 30d after vaccination. Results A total of 644 cases were observed,174 cases of adverse reactions occurred,the incidence of adverse reactions was 27.02%,including 172 cases of general reactions and 2 cases of coupling reactions.Among the 172 general reactions,132 cases were local reactions,37 cases were systemic reactions,and 3 cases were local and systemic reactions at the same time.The incidence of local reactions of PPV23 and influenza vaccine was 16.46 %(106/644) and 13.51% (87/644),respectively,and the difference was not statistically significant (χ²=2.200,P=0.140).The local reactions were mainly pain,redness and swelling at the injection site,while the systemic reactions were mainly fever,fatigue and loss of appetite.All patients recovered within one week. Conclusion Simultaneous vaccination of PPV23 and influenza vaccine is safe for COPD patients.