2015年菏泽市15岁以下非脊灰急性弛缓性麻痹病例监测研究

张复臣++马翠荣　韩芳

【摘要】 目的：分析2015年本市15歲以下非脊灰急性弛缓性麻痹（AFP）监测情况，评价非脊灰AFP诊断、治疗和保持无脊灰状态进展情况，为非脊灰AFP诊断、治疗和保持无脊灰提供科学依据。方法：根据AFP专报系统资料、个案调查表、临床诊断资料与脊灰实验室病毒检测结果进行研究。结果：2015年本市共报告非脊灰AFP 21例，无脊灰病例、脊灰疫苗衍生病毒病例、脊灰疫苗高变异病毒病例、脊灰疫苗低变异病毒病例与脊灰疫苗相关病例，15岁以下儿童非脊灰AFP报告病例发病率为1.13/100 000，分布在9县区，呈高度散发。非脊灰AFP 48 h及时调查率为100%，双份合格大便标本采集率100%。未检测到脊灰野病毒、脊灰疫苗衍生病毒、脊灰疫苗高变异病毒与脊灰疫苗低变异病毒，未分离到脊灰疫苗病毒，非脊灰肠道病毒分离率为14.29%。非脊灰AFP分类中，格林巴利综合征、脊髓炎、脑脊髓炎、脑炎、重症肌无力、神经损伤、其他非脊灰麻痹病例，分别占19.05%、19.05%、9.52%、4.76%、4.76%、4.76%、38.10%。结论：本市非脊灰AFP诊断、治疗、监测和保持无脊灰状态取得了较大进展，但仍有不足之处。要加强非脊灰AFP诊断、治疗与监测，要做好脊灰疫苗免疫策略转换，完善消灭脊灰免疫策略，严格把控握Ⅰ+Ⅲ型脊灰减毒活疫苗接种禁忌证，不断提高脊灰疫苗全程接种率。

【关键词】 非脊灰急性弛缓性麻痹； 脊髓灰质炎； 诊断； 治疗； 监测

Surveillance on Non-polio Acute Flaccid Paralysis Cases Under the Age of 15 of 2015 in Heze City/ZHANG Fu-chen，MA Cui-rong，HAN Fang.//Medical Innovation of China，2017，14（26）：089-094

【Abstract】 Objective：To analysis the surveillance situation of non polio acute flaccid paralysis（AFP） cases under the age of 15 of 2015 in Heze city，evaluation of non-polio AFP diagnosis，treatment and the status of non-polio status，providing scientific evidence for the diagnosis，treatment and the status of non-polio status.Method：The analysis was based on direct reporting network system of AFP cases，epidemiological survey，clinical diagnosis and laboratory virus separation results.Result：21 cases of non-polio AFP were reported in Heze city 2015，There were no polio AFP cases and polio vaccine derived virus cases， polio vaccine high variant virus cases，polio vaccine low variation virus cases，and polio vaccine related case.The incidence of non-polio AFP case of children under 15 years was 1.13/100 000，21 cases of non-polio AFP were distributed in 9 counties of the city，were highly distributed.Timely investigation rate in 48 h of no polio AFP cases was 100%，the adequate collected rate of stool specimen was 100%.Isolated wild polio virus，polio vaccine derived virus and polio vaccine variation virus were not detected，isolated polio vaccine virus was not separated and the separation rate of non-polio enterovirus was 14.29%.In the non polio AFP classification，guillain-Barresyndrome，myelitis，encephalomyelitis，encephalitis，myasthenia gravis，nerve damage and other non-polio paralyzed cases respectively accounted for 19.05%，19.05%，9.52%，4.76%，4.76%，4.76% and 38.10%.Conclusion：Diagnosis，treatment and surveillance of non-polio AFP cases of Heze city and maintaining polio-free status has made a great progress，but still has shortcomings.Diagnosis and treatment and surveillance of non-polio AFP cases still should be strengthened，to do better polio vaccine immunization strategy transformation，improve the polio eradication immunization strategy，strictly grasp Ⅰ+Ⅲ polio live attenuate vaccine contraindications to vaccination，constantly improvet the polio vaccine coverage.endprint

【Key words】 Non polio acute flaccid paralysis； Polio； Diagnosis； Treatment； Surveillance

First-authors address：Heze Center for Disease Control and Prevention，Heze 274010，China

doi：10.3969/j.issn.1674-4985.2017.26.023

本市自1991年以来未发现脊髓灰质炎（脊灰）野病毒病例，保持了无脊灰状态。为保持无脊灰状态和各类非脊灰急性弛缓性麻痹（AFP）的诊断、治疗提供科学依据，对2015年菏泽市15岁以下非脊灰AFP监测作一分析研究，现报道如下。……