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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 簡國龍(Kuo- Liong Chien) | |
| dc.contributor.author | Shin-Rong Ke | en |
| dc.contributor.author | 柯欣榮 | zh_TW |
| dc.date.accessioned | 2021-06-15T02:40:35Z | - |
| dc.date.available | 2009-09-16 | |
| dc.date.copyright | 2009-09-16 | |
| dc.date.issued | 2009 | |
| dc.date.submitted | 2009-08-11 | |
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Chronic Bronchitis and Acute Infections as New Risk Factors for Ischemic Stroke and the Lack of Protection Offered by the Influenza Vaccination. Cerebrovascular disease 2008;26(4):339-347. 28. Morteza Naghavi MZB, MD. Association of Influenza Vaccination and Reduced Risk of Recurrent Myocardial Infarction. Circulation. 2000;102:3039-3045. 29. Heffelfinger JD, Heckbert SR, Psaty BM, Weiss NS, Thompson WW, Bridges CB, Jackson LA. Influenza Vaccination and Risk of Incident Myocardial Infarction. Human Vaccines. 2006;2(4):161-166. 30. Lisa A. Jackson OY, Susan R. Heckbert. Influenza Vaccination Is Not Associated with a Reduction in the Risk of Recurrent Coronary Events. American Journal of Epidemiology. 2002;156(7):634-640. 31. Kristin L. Nichol MD, M.P.H., M.B.A., James Nordin, M.D., M.P.H., John Mullooly, Ph.D. Influenza Vaccination and Reduction in Hospitalizations for Cardiac Disease and Stroke among the Elderly. N Engl J Med. 2003;348:1322-1332. 32. Enrique P. Gurfinkel M, PhD. Influenza Vaccine Pilot Study in Acute Coronary Syndromes and Planned Percutaneous Coronary Interventions The FLU Vaccination Acute Coronary Syndromes (FLUVACS) Study. Circulation. 2002;105:2143-2147. 33. Andrzej Ciszewski ZTB. Influenza vaccination in secondary prevention from coronary ischaemic events in coronary artery disease: FLUCAD study. European Heart Journal. 2008. 34. Charlson M, Ales K, Pompei P. A new method of classification of prognostic comorbidity for longitudinal studies: development and validation. J Chron Disease 1987;40:373-383. 35. Charlson M, Szatrowski TP, Peterson J. Validation of a combined comobidity index. J Clin Epidemiol. 1994;47(11):1245-1251. 36. Chong-Shan Wang S-TW. Impact of influenza vaccination on major cause-specific mortality. Vaccine. 2007;25(7):1196-1203. 37. Jackson LA, Nelson JC, Benson P, Neuzil KM, Reid RJ, Psaty BM, Heckbert SR, Larson EB, Weiss NS. Functional status is a confounder of the association of influenza vaccine and risk of all cause mortality in seniors. Int. J. Epidemiol. 2006;35(2):345-352. 38. Voordouw ACG, Sturkenboom MCJM, Dieleman JP, Stijnen T, Smith DJ, van der Lei J, Stricker BHC. Annual Revaccination Against Influenza and Mortality Risk in Community-Dwelling Elderly Persons. JAMA. 2004;292(17):2089-2095. 39. Groenwold RHH, Hoes AW, Hak E. Impact of influenza vaccination on mortality risk among elderly. Eur Respir J. 2009:09031936.00190008. 40. Jackson LA, Jackson ML, Nelson JC, Neuzil KM, Weiss NS. Evidence of bias in estimates of influenza vaccine effectiveness in seniors. Int. J. Epidemiol. 2006;35(2):337-344. 41. Goodwin K, Viboud Ce. Antibody response to influenza vaccination in the elderly: A quantitative review. Vaccine. 2006;24:1159-1169. 42. Ralph B. DÕAgostino J. Tutorial in biostatistics: propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Statistics in Medicine. 1998;17:2265-2281. 43. Blackstone EH. Comparing apples and oranges. The Journal of Thoracic and Cardiovascular Surgery. 2002;123:8-15. 44. Shah BR, Laupacis A, Hux JE. Propensity score methods gave similar results to traditional regression modeling in observational studies: a systematic review. Journal of Clinical Epidemiology. 2005;58:550-559. 45. Cepeda MS, Boston R, Farrar JT, Strom BL. Comparison of Logistic Regression versus Propensity Score When the Number of Events Is Low and There Are Multiple Confounders. Am. J. Epidemiol. 2003;158(3):280-287. 46. Winkelmayer WC, Kurth T. Propensity scores: help or hype? Nephrol. Dial. Transplant. 2004;19(7):1671-1673. 47. Mac Donald RB, Leslie; Nelson, Andrew; Nichol, Kristin L. . Validation of self-report of influenza and pneumococcal vaccination status in elderly outpatients Am J Prev Med. 1999;16(3):173-177. 48. Zimmerman RK, Raymund M, Janosky JE, Nowalk MP, Fine MJ. Sensitivity and specificity of patient self-report of influenza and pneumococcal polysaccharide vaccinations among elderly outpatients in diverse patient care strata. Vaccine. 2003;13-14:1486-1491. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/44115 | - |
| dc.description.abstract | 背景: 在老人族群，許多觀察性研究發現流行感冒疫苗可以減少後續全死因死亡的危險，但這些研究卻存在方法學上的爭議。此外，流行感冒疫苗是否可以降低老人族群發生急性心血管疾病的危險，則還沒有定論。
研究方法: 本研究採用回溯性世代研究，分析在2007年到2008年間，醫院的老年門診病人接受流感疫苗對全死因死亡以及心血管急症的影響。資料收集方式包括病患的病歷資料以及電話訪問。研究的預後為全死因死亡以及心血管急症.心血管急症的範圍包括急性心肌梗塞，心因性死亡，心因性急診求診，心因性住院，冠狀動脈再通術，以及急性腦血管疾病。研究追蹤的時間為流感盛行季節以及全季節 (定義為流感季節以及之後到十月一日前的時間)。 分析的方法分為兩部分，首先使用Cox proportional hazards model，對於共變因子作迴歸分析;之後採取propensity score matching的方法，選出匹配的個案作比較。 結果: 在2007-2008年，本研究收入接受流感疫苗者有445人，未接受疫苗者有318人。追蹤時間中位數為12個月(Q1: 11個月，Q3: 12個月)，平均追蹤時間為11.3個月，其中發生31例死亡以及75例心血管急症。在全死因死亡部分，流感疫苗顯著的減少死亡的危險(在流感季節，hazard ratio 0.16，95% CI 0.045-0.57;在全季節，hazard ratio 0.15，95% CI 0.054-0.42)。而在心血管急症部分，流感疫苗並沒有減少危險(在流感季節 hazard ratio 0.65, 95% CI 0.33-1.28，在全季節: hazard ratio 0.81, 95% CI 0.50-1.31).經過propensity score match之後，接受疫苗與未接受疫苗各選出了251個匹配的個案。在全死因部分，匹配後的分析仍然顯示流感疫苗可以顯著的減少死亡危險 (在流感季節: hazard ratio 0.08，95% CI 0.01-0.59;在全季節: hazard ratio 0.1，95% CI 0.02-0.43) 。而在心血管急症，流感疫苗並沒有顯著的減少發生危險 (在流感季節: hazard ratio 0.58，95% CI 0.23-1.48; 在全季節: hazard ratio 0.64，95% CI 0.33-1.24)。 結論: 在老人族群，流感疫苗可以減少後續死亡的危險;在心血管急症，則沒有發現有顯著的保護效果。 | zh_TW |
| dc.description.abstract | Background: Influenza vaccination was reported to prevent all-cause death and hospitalization in the elderly. However, it is not clear whether influenza vaccination prevent acute cardiovascular events in this group.
Method: We conducted a retrospective, hospital based cohort study during the 2007-2008 to assess the influence of influenza vaccine on the risk of all cause death and cardiovascular events. The follow-up periods were influenza season and whole season. The information was collected by telephone survey and medical record. Cox proportional hazards model and propensity score matching were used for analysis. Result: A total of 445 vaccinated patient and 318 non-vaccinated patients were included in our study. Median follow-up time was 12 (interquartile range: 11-12) month. During the follow-up period, 31 cases of all-cause death and 75 cases of acute cardiovascular event were noted. Vaccination was associated with lower risk of all-cause death (in influenza season: hazard ratio 0.16, 95% confidence interval 0.045-0.57; in whole season: hazard ratio 0.15, 95% confidence interval 0.054-0.42). In cardiovascular event, vaccination was associated with non-significant risk reduction (in influenza season: hazard ratio 0.65, 95% confidence interval 0.33-1.28; in whole season: hazard ratio 0.81, 95% confidence interval 0.50-1.31). By propensity score 1:1 matching, 251 matched pairs in the vaccinated and non-vaccinated group were investigated. In all- cause death, vaccination was associated with significant risk reduction (in influenza season: hazard ratio 0.08; 95% confidence interval 0.01-0.59; in whole season: hazard ratio 0.1; 95% confidence interval 0.02-0.43). In cardiovascular events, vaccination was associated with non-significant risk reduction (in influenza season: hazard ratio 0.58, 95% confidence interval 0.23-1.48; in whole season: hazard ratio 0.64, 95% confidence interval 0.33-1.24). In the subgroup analysis, influenza vaccine showed a borderline protective effect on acute cardiovascular event in subjects with younger age (hazard ratio 0.31, 95% confidence interval 0.09-1.14) and preexisting cardiovascular disease (hazard ratio 0.57, 95% confidence interval 0.26-1.24) in the influenza season. Conclusion: In the elderly, influenza vaccination reduced the risk of all- cause death both in influenza season and whole season. However, the vaccination did not have significant protective effect on cardiovascular event among elder ethnic Chinese. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-15T02:40:35Z (GMT). No. of bitstreams: 1 ntu-98-R96846011-1.pdf: 568075 bytes, checksum: b8ceadde5f6e8f188fb80b3d741952c4 (MD5) Previous issue date: 2009 | en |
| dc.description.tableofcontents | 口試委員會審定書 I
中文摘要 II 英文摘要 IV 目錄 VI Tables VIII Figures IX 第一章 研究背景 1 第一節 季節性流感與急性冠心症的關係 1 第二節 流行性感冒疫苗注射的效果及其對心血管系統的影響 3 1.2.1 流感疫苗簡介及現狀 3 1.2.2注射流感疫苗對心血管系統的影響: 短期的影響 7 1.2.3流感疫苗預防急性心血管疾病的機制 8 1.2.4流感疫苗與急性腦血管疾病的關係 8 第三節 流感疫苗對心血管疾病預防效果的文獻回顧 9 1.3.1 病例對照研究 (case control study) 9 1.3.2世代研究 (cohort study) 11 1.3.3隨機對照試驗 (Randomized control trial) 12 第二章: 研究目的與研究假說 15 研究目的 15 研究假說 15 第三章: 研究方法 16 第一節 研究架構 16 第二節 研究對象及選取 16 第三節 研究資料內容 17 第四節 資料收集方式 20 第五節 統計方法 21 第六節 樣本數的估計 24 第四章 研究結果 25 第一節 2007-2008年流行感冒疫病狀況 25 第二節 資料取得狀況與基本資料分析 26 第三節 預後指標分析 27 第四節 次族群分析 30 第五節 propensity score match及分析 31 第五章 討論 33 第一節 全死因死亡的探討 33 第二節 心血管急症的探討 35 第三節 使用propensity score的探討 39 第四節 研究優點及限制 41 第四節 研究優點及限制 41 第五節 結論與未來方向 44 參考文獻 46 | |
| dc.language.iso | zh-TW | |
| dc.subject | 死亡 | zh_TW |
| dc.subject | 流感疫苗 | zh_TW |
| dc.subject | 急性心肌梗塞 | zh_TW |
| dc.subject | 老人 | zh_TW |
| dc.subject | 冠狀動脈疾病 | zh_TW |
| dc.subject | coronary artery disease | en |
| dc.subject | influenza vaccine | en |
| dc.subject | acute myocardial infarction | en |
| dc.subject | mortality | en |
| dc.subject | elderly | en |
| dc.title | 流感疫苗注射在台灣老年族群與後續全死因及心血管疾病的相關性 | zh_TW |
| dc.title | Influenza vaccination and the risk of all-cause death and cardiovascular event among Taiwanese elderly | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 97-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 季瑋珠,江福田,方啟泰,陳宜君 | |
| dc.subject.keyword | 流感疫苗,急性心肌梗塞,老人,冠狀動脈疾病,死亡, | zh_TW |
| dc.subject.keyword | influenza vaccine,elderly,coronary artery disease,mortality,acute myocardial infarction, | en |
| dc.relation.page | 74 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2009-08-11 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 預防醫學研究所 | zh_TW |
| 顯示於系所單位： | 流行病學與預防醫學研究所 | |
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