天津市急性弛缓性麻痹患者病原学分析

Pathogenic Analysis on Acute Flaccid Paralysis in Tianjin

目的:了解天津市无脊髓灰质炎(脊灰)状态下急性弛缓性麻痹(AFP)患者病原学检测情况。方法:收集AFP患者和密切接触者的粪便标本,用表达了人类脊灰病毒受体的小鼠细胞系(L20B)和来源于人横纹肌肉瘤的细胞系(RD)细胞分离脊灰病毒,用世界卫生组织(WHO)推荐的定型血清进行脊灰病毒(PV)和非脊髓灰质炎肠道病毒(NPEV)的分型,采用逆转录-聚合酶链反应-限制性酶切片段长度多态性分析方法对PV进行型内鉴定。结果:2000—2005年收集AFP患者粪便标本302份,检出PV32株,检出率为10.60%,均为疫苗相关株;检出NPEV11株,检出率为3.64%;检出肠道病毒(EV)总数为43株,总检出率为14.24%。共检测粪便标本总数为954份(其中包括本市及外省AFP病例、密切接触者的粪便标本)从中检出PV63株,检出率为6.60%,检测出的PV均为疫苗相关株;检出NPEV77株,检出率为8.07%;检出EV总数为140株,总检出率为14.68%。结论:AFP患者中未发现脊灰野病毒及其他脊灰病毒衍生株。

Objective： To study the pathogen of acute flaccid paralysis （AFP） with polio free status in Tianjin. Methods： The feces specimens of AFP cases and AFP close contacts were collected. The poliovirus （PV） and other Nonpolio enterovirus （NPEV） were isolated and identified with L20B and RD cell lines by typing sera recommended by WHO. Polioviruses intratypic differentiation was studied by reverse transcriptase-polymerase chain reaction restriction fragment length polymorphism （RT-PCR-RFLP）. Results： Thirty-two polioviruses were isolated from 302 AFP feces specimens collected from 2000 to 2005 with the rate of 10.06% which were all vaccine associated strains. Eleven non-polio enteroviruses were isolated with the rate of 3.64%. Forty-three enteroviruses （EV） were isolated with the total rate of 14.24%. Sixty-three polioviruses were isolated from 954 feces specimens （which contained AFP cases from local province and other province and close contacts） collected from 2000 to 2005 with the rate of 6.60% which were all vaccine associated strains. Seventy-seven non-polio enteroviruses were isolated with the rate of 8.07%. One hundred and forty enteroviruses were isolated with the total rate of 14.68%. Conclusion： No wild poliovirus or other polio-derivation is found in AFP cases.