深圳市2001-2011年残留麻痹的急性弛缓性麻痹病例情况分析

Analysis on the situation of residual paralysis of acute flaccid paralysis cases from 2001 to 2011 in Shenzhen City

目的了解深圳市2001-2011年残留麻痹的继续弛缓性麻痹(acute flaccid paralysis,AFP)病例流行病特征,提高AFP监测质量。方法对深圳市2001-2011年残留麻痹AFP病例个案资料和病原学检测结果进行描述性流行病学分析。结果深圳市2001-2011年共报告残留麻痹AFP病例60例,主要发生在小年龄组儿童,<3岁的儿童40例,占66.67%;发病高峰为4～8月,男女比例为1.61∶1;麻痹部位以双下肢麻痹较多,其次为四肢肢体麻痹;残留麻痹的AFP病例以疫苗相关病例(VAPP)和格林巴利综合征(GBS)为主,其次为横贯性脊髓炎、创伤性神经炎等。结论 VAPP的发生是接种脊髓灰质炎减毒活疫苗(OPV)难以克服的弱点,为减少VAPP病例及防止脊灰疫苗衍生病毒(VDPV)的发生,应在消灭脊灰后期科学、合理地调整消灭脊灰的免疫策略。

Objective To understand the epidemiological characteristics of the residual paralysis of acute flaccid paralysis （AFP） cases and to raise quality of the AFP surveillance. Methods The data of AFP cases and the results of pathogenic detection were analyzed by description epidemiological method. Results A total of 60 residual paralysis of AFP cases were reported in Shenzhen from 2001 to 2011, which occurred mainly in children at low age. There were 40 cases of children less than 3 years old, accounting for 66.67%. The peak incidence of the residual paralysis cases concentrated from April to August and the ratio of male to female was 1.61： 1. The residual paralysis was mainly on both lower limbs, secondly was on unilateral lower limbs. The cases of residual paralysis of AFP were mainly VAPP cased and Guillain - Barre Snydrome and followed by transverse myelitis, traumatic neuritis and so on. Conclusions The occurrence of VAPP was the serious weakness of OPV. In order to reduce the VAPP cases and prevent the occurrence of VDPV, we should scientifically and reasonably adjust the immunization policy in the later stage of eradication of polio.