Follow Us:Respiratio 2019; 9 (1-2): 120-126
UTICAJ KOMORBIDITETA NA POJAVU EGZACERBACIJA MEĐU
OBOLELIM OD HOBP USLED ZAPOSTAVLJENE IMUNIZACIJE PROTIVSEZONSKOG GRIPA
THE INFLUENZE OF COMORBIDITY ON ACUTE EXACERBATION AMONG COPD PATIENTS
BECAUSE TO NEGLECT IMMUNIZATION AGAINST SEASONAL FLU
Miroslav Ilić, Marija Vukoja, Aleksandra Vulin, Ivan Kopitović
Original research
Naučni članak
Sažetak
Uvod: Smernice, Svetske zdravstvene organizacije (SZO), Centra za kontrolu bolesti SAD (CDC) i
nacionalne, preporučuju imunizaciju protiv virusa gripe (nivo dokaza A, stepen preporuke 1) među
pacijentima starijih od 65 godina i posebno među hroničarima. Egzacerbacije hronične opstruktivne
bolesti pluća (HOBP) često nastaju usled infekcija virusima, najčešće virusi influence (gripa). Međutim,
stepen imunizacije je i dalje niži od preporučenog kako kod nas, tako i u razvijenim zemljama.
Cilj rada je bio da se utvrdi učestalost i efektivnost imunizacije protiv sezonskog gripa u cilju
prevencije egzacerbacija kod HOBP pacijenata sa komorbiditetima.
Metod: Sprovedena je prospektivna studija kod ambulantnih HOBP pacijenata u trogodišnjem
periodu (2014 – 2017) u Polikliničkoj službi Instituta za plućne bolesti Vojvodine, Sremska Kamenica.
Povezanost vakcinacije i HOBP egzacerbacija, kao i starosti i komorbiditeta ispitivana je u
univarijantnoj i multivarijantnoj logističkoj regresionoj analizi.
Rezultati: Studija je obuhvatila 840 pacijenata (468 muškaraca); 37,1% pacijenta je vakcinisano
protiv sezonskog gripa. Komorbiditete je imalo 741 pacijent, najčešće je bio povišen krvni pritisak (597,
71.1 %) i diabetes mellitus (180; 21.4%). Egzacerbacije HOBP su bile češće kod nevakcinisanih
pacijenata (176 (31.9%) vs. 375 (68.2%), p=0.043). Stariji, vakcinisani pacijenti (≥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 pacijenata sa komorbiditetima (165 (61.1%) vs. 327
(69.4%), p=0.021). U multivarijantnoj analizi su nezavisni prediktor pojave egzacerbacije je bila srčana
slabost (RR 2.734; 95% CI (1.121 - 6.669); p=0.027).
Zaključak: Imunizacija protiv sezonskog gripa i dalje je ispod preporučenog nivoa. Vakcinacija
protiv sezonskog gripa značajno redukuje egzacerbacije među HOBP pacijentima, posebno kod starijih i
sa kardijalnim komorbiditetom.
Ključnereči: komorbiditet, vakcinacija, grip, HOBP, egzacerbacija
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Miroslav Ilić,
Institut za plućne bolesti Vojvodine,
Sremska Kamenica,
mail: This email address is being protected from spambots. You need JavaScript enabled to view it., This email address is being protected from spambots. You need JavaScript enabled to view it.