筛选临床高危脊髓灰质炎病例的方法

A Method for Screening High-risk Cases of Clinical Poliomyelitis

在消灭脊髓灰质炎（脊灰）的最后阶段，如何根据临床信息尽早发现高危脊灰病例，以便采取针对性措施，阻断野病毒的流行是一个值得探讨的问题。山东省资料表明，用＜５岁、麻痹伴发热、肌力＜３级、腱反射减弱４个因素并综合考虑免疫史因素，作为高危脊灰病例早期临床筛检指标，可达到较高的敏感性和特异性。在晚期病例诊断中，＜５岁、６０天残留麻痹、腱反射减弱或消失作为临床符合病例的诊断指标，既满足了高敏感性，又达到了较高特异性。在各级医院诊断特异性和阳性预测值不高的情况下。

In the last stage of polio eradication program,it is an problem how to find out high-risk polio cases earlier for any control strategy to use.By using the indexes that are under 5 years old,fever at onset of paralysis,muscular power less than grade 3,tendon reflection decreases or loses and OPV vaccination less than 3 times,we can get higher sensitivity and specificity to find out the high risk polio cases in the early stage.By using indexes of under 5 years old,residual paralysis after 60 days of onset and tendon reflection decreases or loses,it can achieve higher screening sensitivity and specificity for clincal compatible cases in the late stage.It is very important to find out the high-risk polio cases by using these indexes especially when the hospital diagnosis on specificity and the predicated values are not so high.