{"id":17736,"date":"2019-09-14T05:37:41","date_gmt":"2019-09-13T21:37:41","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=17736"},"modified":"2019-09-27T05:39:10","modified_gmt":"2019-09-26T21:39:10","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%8c%bb%e5%8a%a1%e4%ba%ba%e5%91%98%e4%bd%a9%e6%88%b4n95%e5%8f%a3%e7%bd%a9%e6%88%96%e5%8c%bb%e5%ad%a6%e5%8f%a3%e7%bd%a9%e9%a2%84%e9%98%b2%e6%b5%81","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=17736","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u533b\u52a1\u4eba\u5458\u4f69\u6234N95\u53e3\u7f69\u6216\u533b\u7528\u53e3\u7f69\u9884\u9632\u6d41\u611f"},"content":{"rendered":"\n

Original Investigation September 3, 2019<\/p>\n\n\n\n

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel: A Randomized Clinical Trial<\/h1>\n\n\n\n

Lewis J. Radonovich Jr, Michael S. Simberkoff, Mary T. Bessesen, et al<\/h3>\n\n\n\n

JAMA. <\/em>2019;322(9):824-833. doi:10.1001\/jama.2019.11645<\/h3>\n\n\n\n

Abstract<\/h3>\n\n\n\n

Importance<\/strong>\u00a0\u80cc\u666f<\/h3>\n\n\n\n

Clinical studies have been inconclusive about the effectiveness of N95 respirators and medical masks in preventing health care personnel (HCP) from acquiring workplace viral respiratory infections.<\/p>\n\n\n\n

\u6709\u5173N95\u53e3\u7f69\u548c\u533b\u7528\u9884\u9632\u533b\u52a1\u4eba\u5458(HCP)\u5728\u5de5\u4f5c\u573a\u6240\u4f20\u67d3\u75c5\u6bd2\u6027\u547c\u5438\u9053\u611f\u67d3\u7684\u4f5c\u7528\uff0c\u4e34\u5e8a\u7814\u7a76\u7ed3\u679c\u5e76\u4e0d\u4e00\u81f4<\/p>\n\n\n\n

Objective<\/strong>\u00a0\u76ee\u7684<\/h3>\n\n\n\n

To compare the effect of N95 respirators vs medical masks for prevention of influenza and other viral respiratory infections among HCP.<\/p>\n\n\n\n

\u6bd4\u8f83N95\u53e3\u7f69\u4e0e\u533b\u7528\u53e3\u7f69\u9884\u9632HCP\u6d41\u611f\u53ca\u5176\u4ed6\u75c5\u6bd2\u6027\u547c\u5438\u9053\u611f\u67d3\u7684\u6548\u679c\u3002<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>\u00a0\u8bbe\u8ba1\uff0c\u573a\u666f\u53ca\u7814\u7a76\u5bf9\u8c61<\/h3>\n\n\n\n

A cluster randomized pragmatic effectiveness study conducted at 137 outpatient study sites at 7 US medical centers between September 2011 and May 2015, with final follow-up in June 2016. Each year for 4 years, during the 12-week period of peak viral respiratory illness, pairs of outpatient sites (clusters) within each center were matched and randomly assigned to the N95 respirator or medical mask groups.<\/p>\n\n\n\n

2011\u5e749\u6708\u81f32015\u5e745\u6708\uff0c\u7f8e\u56fd7\u4e2a\u533b\u5b66\u4e2d\u5fc3\u7684137\u4e2a\u95e8\u8bca\u90e8\u8fdb\u884c\u4e86\u4e00\u9879\u7fa4\u7ec4\u968f\u673a\u3001\u5b9e\u6548\u6027\u7814\u7a76\uff0c\u6700\u540e\u968f\u8bbf\u65e5\u671f\u4e3a2016\u5e746\u6708\u3002\u5728\u4e3a\u671f4\u5e74\u7684\u7814\u7a76\u671f\u95f4\uff0c\u6bcf\u5e74\u75c5\u6bd2\u6027\u547c\u5438\u9053\u75be\u75c5\u6700\u4e3a\u6d41\u884c\u768412\u5468\u5185\uff0c\u6bcf\u4e2a\u533b\u5b66\u4e2d\u5fc3\u4e2d\u7684\u95e8\u8bca\u90e8\u914d\u5bf9\uff08\u7fa4\u7ec4\uff09\u8fdb\u884c\u5339\u914d\uff0c\u5e76\u968f\u673a\u5206\u4e3aN95\u53e3\u7f69\u6216\u533b\u7528\u53e3\u7f69\u7ec4\u3002<\/p>\n\n\n\n

Interventions<\/strong>\u00a0\u5e72\u9884\u63aa\u65bd<\/h3>\n\n\n\n

Overall, 1993 participants in 189 clusters were randomly assigned to wear N95 respirators (2512 HCP-seasons of observation) and 2058 in 191 clusters were randomly assigned to wear medical masks (2668 HCP-seasons) when near patients with respiratory illness.<\/p>\n\n\n\n

189\u4e2a\u7fa4\u7ec4\u5171\u8ba11993\u540d\u53d7\u8bd5\u8005\u968f\u673a\u5206\u81f3N95\u53e3\u7f69\u7ec4\uff0c\u5373\u63a5\u8fd1\u547c\u5438\u9053\u75be\u75c5\u60a3\u8005\u65f6\u4f69\u6234N95\u53e3\u7f69\uff082512\u4e2aHCP\u89c2\u5bdf\u5b63\u8282\uff09\uff0c191\u4e2a\u7fa4\u7ec4\u76842058\u540d\u53d7\u8bd5\u8005\u968f\u673a\u5206\u81f3\u533b\u7528\u53e3\u7f69\u7ec4\uff082668\u4e2aHCP\u89c2\u5bdf\u5b63\u8282\uff09\u3002<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>\u00a0\u4e3b\u8981\u9884\u540e\u6307\u6807<\/h3>\n\n\n\n

The primary outcome was the incidence of laboratory-confirmed influenza. Secondary outcomes included incidence of acute respiratory illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness, and influenzalike illness. Adherence to interventions was assessed.<\/p>\n\n\n\n

\u4e3b\u8981\u9884\u540e\u6307\u6807\u4e3a\u5b9e\u9a8c\u5ba4\u786e\u8bca\u7684\u6d41\u611f\u53d1\u75c5\u7387\u3002\u6b21\u8981\u9884\u540e\u6307\u6807\u5305\u62ec\u6025\u6027\u547c\u5438\u9053\u75be\u75c5\u3001\u5b9e\u9a8c\u5ba4\u68c0\u6d4b\u7684\u547c\u5438\u9053\u611f\u67d3\u3001\u5b9e\u9a8c\u5ba4\u786e\u8bca\u7684\u547c\u5438\u9053\u75be\u75c5\u53ca\u6d41\u611f\u6837\u75c5\u4f8b\u7684\u53d1\u75c5\u7387\u3002\u6211\u4eec\u5bf9\u5e72\u9884\u63aa\u65bd\u7684\u4f9d\u4ece\u6027\u8fdb\u884c\u4e86\u8bc4\u4f30\u3002<\/p>\n\n\n\n

Results<\/strong>\u00a0\u7ed3\u679c<\/h3>\n\n\n\n

Among 2862 randomized participants (mean [SD] age, 43 [11.5] years; 2369 [82.8%]) women), 2371 completed the study and accounted for 5180 HCP-seasons. There were 207 laboratory-confirmed influenza infection events (8.2% of HCP-seasons) in the N95 respirator group and 193 (7.2% of HCP-seasons) in the medical mask group (difference, 1.0%, [95% CI, \u22120.5% to 2.5%];\u00a0P<\/em>\u2009=\u2009.18) (adjusted odds ratio [OR], 1.18 [95% CI, 0.95-1.45]). There were 1556 acute respiratory illness events in the respirator group vs 1711 in the mask group (difference, \u221221.9 per 1000 HCP-seasons [95% CI, \u221248.2 to 4.4];\u00a0P<\/em>\u2009=\u2009.10); 679 laboratory-detected respiratory infections in the respirator group vs 745 in the mask group (difference, \u22128.9 per 1000 HCP-seasons, [95% CI, \u221233.3 to 15.4];\u00a0P<\/em>\u2009=\u2009.47); 371 laboratory-confirmed respiratory illness events in the respirator group vs 417 in the mask group (difference, \u22128.6 per 1000 HCP-seasons [95% CI, \u221228.2 to 10.9];\u00a0P<\/em>\u2009=\u2009.39); and 128 influenzalike illness events in the respirator group vs 166 in the mask group (difference, \u221211.3 per 1000 HCP-seasons [95% CI, \u221223.8 to 1.3];\u00a0P<\/em>\u2009=\u2009.08). In the respirator group, 89.4% of participants reported \u201calways\u201d or \u201csometimes\u201d wearing their assigned devices vs 90.2% in the mask group.<\/p>\n\n\n\n

\u5171\u67092862\u4eba\u63a5\u53d7\u968f\u673a\u5206\u7ec4\uff08\u5e73\u5747 [SD] \u5e74\u9f84\uff0c43 [11.5] \u5c81\uff1b2369 [82.8%] \u540d\u5973\u6027\uff09\uff0c\u5176\u4e2d2371\u4eba\u5b8c\u6210\u7814\u7a76\uff0c\u5171\u8ba15180\u4e2aHCP\u5b63\u8282\u3002N95\u53e3\u7f69\u7ec4\u5b9e\u9a8c\u5ba4\u786e\u8bca\u6d41\u611f\u611f\u67d3\u75c5\u4f8b207\u4f8b\uff08HCP\u5b63\u8282\u76848.2%\uff09\uff0c\u533b\u7528\u53e3\u7f69\u7ec4193\u4f8b\uff08HCP\u5b63\u8282\u76847.2%\uff09\uff08\u5dee\u5f021.0%\uff0c[95% CI, \u22120.5% to 2.5%];\u00a0P<\/em>\u2009=\u2009.18\uff09\uff08\u6821\u6b63\u6bd4\u6570\u6bd4[OR]\uff0c1.18 [95% CI, 0.95-1.45]\uff09\u3002N95\u53e3\u7f69\u7ec4\u53d1\u751f1556\u4f8b\u6025\u6027\u547c\u5438\u9053\u75be\u75c5\uff0c\u533b\u7528\u53e3\u7f69\u7ec4\u4e3a1711\u4f8b\uff08\u5dee\u5f02\uff0c\u6bcf1000\u4e2aHCP\u5b63\u8282\u221221.9\u4f8b [95% CI, \u221248.2 to 4.4];\u00a0P<\/em>\u2009=\u2009.10\uff09\uff1bN95\u53e3\u7f69\u7ec4\u53d1\u751f679\u4f8b\u5b9e\u9a8c\u5ba4\u68c0\u6d4b\u7684\u547c\u5438\u9053\u611f\u67d3\uff0c\u533b\u7528\u53e3\u7f69\u7ec4\u4e3a745\u4f8b\uff08\u5dee\u5f02\uff0c\u6bcf1000\u4e2aHCP\u5b63\u8282\u22128.9\u4f8b\uff0c[95% CI, \u221233.3 to 15.4];\u00a0P<\/em>\u2009=\u2009.47\uff09\uff1bN95\u53e3\u7f69\u7ec4\u53d1\u751f\u5b9e\u9a8c\u5ba4\u786e\u8bca\u7684\u547c\u5438\u9053\u75be\u75c5371\u4f8b\uff0c\u533b\u7528\u53e3\u7f69\u7ec4 417 \u4f8b\uff08\u5dee\u5f02\uff0c\u6bcf1000\u4e2aHCP\u5b63\u8282 \u22128.6 \u4f8b [95% CI, \u221228.2 to 10.9];\u00a0P<\/em>\u2009=\u2009.39\uff09\uff1bN95\u53e3\u7f69\u7ec4\u53d1\u751f\u6d41\u611f\u6837\u75c5\u4f8b 128 \u4f8b\uff0c\u533b\u7528\u53e3\u7f69\u7ec4 166 \u4f8b\uff08\u5dee\u5f02\uff0c\u6bcf1000\u4e2aHCP\u5b63\u8282\u221211.3\u4f8b [95% CI, \u221223.8 to 1.3];\u00a0P<\/em>\u2009=\u2009.08\uff09\u3002N95\u53e3\u7f69\u7ec4\u4e2d\uff0c89.4%\u7684\u53d7\u8bd5\u8005\u62a5\u544a\u201c\u603b\u662f\u201d\u6216\u201c\u6709\u65f6\u201d\u4f69\u6234N95\u53e3\u7f69\uff0c\u533b\u7528\u53e3\u7f69\u7ec4\u4e3a90.2%\u3002<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions and Relevance<\/strong>\u00a0\u7ed3\u8bba\u548c\u610f\u4e49<\/h3>\n\n\n\n

Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.<\/p>\n\n\n\n

\u672c\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u5728\u95e8\u8bca\u90e8\u5de5\u4f5c\u7684\u533b\u52a1\u4eba\u5458\u4f69\u6234N95\u53e3\u7f69\u6216\u533b\u7528\u53e3\u7f69\uff0c\u4e0d\u5f71\u54cd\u5b9e\u9a8c\u5ba4\u786e\u8bca\u6d41\u611f\u7684\u53d1\u75c5\u7387\u3002<\/p>\n\n\n\n

Trial Registration<\/strong>\u00a0\u8bd5\u9a8c\u6ce8\u518c<\/h3>\n\n\n\n

ClinicalTrials.gov Identifier: NCT01249625<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation September 3, 2019 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/17736"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=17736"}],"version-history":[{"count":3,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/17736\/revisions"}],"predecessor-version":[{"id":17744,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/17736\/revisions\/17744"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=17736"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=17736"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=17736"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}