503例残留麻痹急性弛缓性麻痹病例病原流行病学特征分析

The epidemiology character of the 503 residual paralysis of acute flaccid paralysis cases

目的分析广东省1994-2007年间残留麻痹病例的病原流行病学特征。方法对1994--2007年广东省503例残留麻痹病例的粪便标本进行病毒分离、血清型鉴定和脊髓灰质炎（脊灰）病毒型内鉴定，并使用统计学方法，综合分析病原学结果与残留麻痹病例的免疫史、性别、年龄等流行病学资料之间的关系。结果收检了503例残留麻痹病例的粪便标本，其中150例分离到脊灰病毒（PV），均为疫苗类似株，59例分离到非脊灰肠道病毒（NPEV），PV和NPEV的年度分离率分别在18．92％～47．06％和4．17％～25．00％之间浮动。PV分离率随年龄组的增大而降低，0岁组最高，为61．11％；0～2次免疫的病例的PV分离率远高于全程免疫者，差异有统计学意义；残留麻痹病例中的PV和NPEV分离率均高于无残留麻痹的病例。结论1994--2007年广东省未发现由脊灰野病毒引起的残留麻痹病例，2岁以下年龄组和0～1剂次免疫者中的PV分离率与残留麻痹有相关性，NPEVs也可能是儿童出现残留麻痹病例的病原之一。

Objective Analyze the epidemiology character of the residual paralysis（RP） of acute flaccid paralysis（AFP） in Guangdong during 1994--2007. Methods The viruses isolated from the excrement of RP cases were identified and typed in Guangdong from 1994 to 2007.Statistics analysis was performed to reveal the relationship among the immunization history, age, gender and the distribution of the etiology. Results A total of 503 RP cases were reported. 150 of which were isolated with PV and 59 were isolated with NPEV. From 1994 to 2007 ,The PV isolating rate ranged from 18.92% to 47.06% and was higher in winter and spring,while the NPEV isolating rate ranged from 4.17% to 25.00%. and was higher in summer and autumn. The PV isolating rate decreased as the age increased, and its isolating rate （61.11% ） was highest in ＂0＂ year group. The PV isolating rate of the population of ≤2 times OPV was far higher than≥3 times. The PV and NPEV isolating rate of the RP cases was higher than without RP. Conclusion The case with RP caused by wild poliovirus wasn＇t found from 1994 to 2007 in Guangdong,but the relationship of RP case was observed between ≤2 years group and ≤ 1 time OPV, and NPEVs probably are the potential etiological agent that cause children RP.