Učestalost i efekti vakcinacije protiv sezonskog gripa na pojavu egzacerbacija hronične opstruktivne bolesti pluća u Srbiji
Sažetak
Uvod/Cilj. Egzacerbacije hronične opstruktivne bolesti pluća (HOBP) često nastaju usled infekcija virusima influence, posebno u zimskim mesecima. Međutim, i u razvijenim zemljama je stepen imunizacije i dalje niži od preporučenog. Cilj rada je bio da se utvrdi učestalost i efektivnost imunizacije protiv sezonskog gripa u cilju prevencije egzacerbacija kod bolesnika sa hroničnom opstruktivnom bolešću pluća (HOBP) u Srbiji. Metode. Prospektivna kohortna studija sprovedena je kod ambulantnih bolesnika sa HOBP, lečenih u periodu od 1.10.2014. do 30.09.2017. u Polikliničkoj službi Instituta za plućne bolesti Vojvodine, Sremska Kamenica. Povezanost vakcinacije i egzacerbacija HOBP, ali i komorbiditeta, starosti i indeksa telesna mase (body mass index - BMI), ispitivana je pomoću univarijantne i multivarijantne logističke regresione analize. Rezultati. Studijom su bila obuhvaćena 840 bolesnika. Protiv sezonskog gripa vakcinisano je 37,1% bolesnika. Egzacerbacije HOBP bile su češće kod nevakcinisanih bolesnika [176 (31,9%) vs. 375 (68,1%), p = 0,043]. Stariji, vakcinisani bolesnici (≥ 65 godina), imali su manje egzacerbacija u odnosu na nevakcinisane [89 (56,0%) vs. 188 (69,4%), p = 0,005]. Manje egzacerbacija je potvrđeno u grupi vakcinisanih bolesnika sa komorbiditetima [165 (61,1%) vs. 327 (69,4%), p = 0,021] i niskim BMI [27 (64,3) vs. 78 (83,9%), p = 0,011]. U multivarijantnoj analizi nezavisni prediktori pojave egzacerbacije su bili BMI > 21 kg/m2 [relativni rizik (RR): 0,490; 95% interval poverenja (CI): 0,318–0,758; p = 0.001] i srčana slabost (RR: 2,734; 95% CI: 1,121–6,669; p = 0.027). Zaključak. Imunizacija protiv sezonskog gripa u Srbiji je i dalje ispod preporučenog nivoa. Vakcinacija protiv sezonskog gripa značajno redukuje egzacerbacije među HOBP pacijentima, posebno kod starijih sa srčanom slabošću i niskim BMI.
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