美推荐流感疫苗接种作为心血管疾病的二级预防

2006-11-03 00:00 来源:丁香园 作者:jackie_zhou1283 译
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来自美国心脏病协会和美国心脏病学会的科学建议

由以下单位支持发起,美国心血管和肺康复协会、美国护理学会、美国心力衰竭护理协会、美国糖尿病协会、黑人心脏学者协会、美国心衰学会、预防心血管护士协会、美国护理从事者学会支持这个科学咨询的建议:该科学咨询建议与美国疾病预防和控制中心以及计划免疫咨询委员会的推荐一致。

队列研究和一项随机临床试验的证据表明,每年预防季节性流感的疫苗注射能减少心血管发病率和因心血管情况而住院病人的全因死亡率。美国心脏病协会和美国心脏病学会推荐使用灭活疫苗进行流感免疫作为患有冠心病和其他动脉粥样硬化血管疾病患者(Class I, Level B)的综合二级预防的一部分。有心血管情况的患者严禁使用活的、减毒疫苗免疫(鼻内给药)。很重要的一点流感疫苗接种整体覆盖水平和总体人群仍远低于美国国家目标,并且在不同年龄和种族差异显著。心血管病患者疫苗接种的障碍之一是心脏病治疗机构经常不采购、接种流感疫苗。通过在流感季节前和整个季节中给患者提供和强力推荐疫苗接种,负责心血管病患者治疗的医疗保健机构能帮助提高流感疫苗接种的覆盖率。

摘自循环杂志10月3日刊


Influenza Vaccination as Secondary Prevention for Cardiovascular Disease

A Science Advisory From the American Heart Association/American College of Cardiology:

Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Association of Critical Care Nurses, the American Association of Heart Failure Nurses, the American Diabetes Association, the Association of Black Cardiologists, Inc., the Heart Failure Society of America, and the Preventive Cardiovascular Nurses Association.: The American Academy of Nurse Practitioners supports the recommendations of this scientific advisory.: This science advisory is consistent with the recommendations of the Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practices.

Evidence from cohort studies and a randomized clinical trial indicates that annual vaccination against seasonal influenza prevents cardiovascular morbidity and all-cause mortality in patients with cardiovascular conditions. The American Heart Association and American College of Cardiology recommend influenza immunization with inactivated vaccine (administered intramuscularly) as part of comprehensive secondary prevention in persons with coronary and other atherosclerotic vascular disease (Class I, Level B). Immunization with live, attenuated vaccine (administered intranasally) is contraindicated for persons with cardiovascular conditions. It is important to note that influenza vaccination coverage levels overall and in this population remain well below national goals and are marked by disparities across different age and ethnic groups. One of the barriers to vaccination for patients with cardiovascular disease is that cardiology practices frequently do not stock and administer influenza vaccine. Healthcare providers who treat individuals with cardiovascular disease can help improve influenza vaccination coverage rates by providing and strongly recommending vaccination to their patients before and throughout the influenza season.
circulationOct. 3


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