中国2014年<15岁儿童吉兰-巴雷综合征流行特征及其残留麻痹影响因素分析

Epidemiological characteristics of Guillain-Barré syndrome and influencing factors of residual paralysis among children under 15 years old in China,2014

目的了解中国(未包括香港、澳门特别行政区和台湾地区,下同)2014年<15岁儿童吉兰-巴雷综合征(Guillain-Barrésyndrome,GBS)流行特征,探索影响GBS残留麻痹的因素。方法采用描述流行病学方法分析急性弛缓性麻痹(Acute flaccid paralysis,AFP)病例监测信息报告管理系统中收集的全国2014年<15岁儿童GBS病例数据。结果中国2014年共报告<15岁儿童GBS 931例,报告发病率为0.41/10万。GBS有肌肉疼痛、四肢麻痹、深部腱反射减弱或消失、感觉障碍、残留麻痹的比例均显著高于其他AFP病例。脊髓灰质炎(脊灰)疫苗免疫史<3剂次、有颈项强直和四肢麻痹、麻痹程度和深部腱反射的交互作用为GBS残留麻痹的危险因素。结论全国<15岁儿童GBS发病水平低;发病严重程度和脊灰疫苗免疫史影响GBS预后;需加强GBS特别是严重病例的及时治疗与管理。

Objective To determine the epidemiological characteristics of Guillain-Barr6 syndrome （GBS） among children under 15 years old, and to identify the factors influencing GBS prognosis in China （excluding Hong Kong Special Administrative Region, Macao Special Administrative Region, and Tai- wan） in 2014. Methods GBS cases were obtained from the Acute Flaccid Paralysis （AFP） Surveil- lance Information Reporting and Management System in China. Descriptive methods were used to analyze data from GBS cases 〈 15 years old in 2014. Results A total of 931 GBS cases were reported, for an incidence rate of 0. 41 per 100 000 population. There was a significantly higher proportion of muscle pain, four-limb paralysis, weakened or absent deep tendon reflexes, sensory disturbance, and residual paralysis among GBS cases than among other AFP cases. Receipt of fewer than 3 doses of polio vaccine, neck rigidity, four-limb paralysis, and a combination of severe paralysis with weakened or absent deep tendon reflexes were risk factors for residual paralysis among GBS cases. Conclusion The incidence of GBS among children less than 15 years of age is low in China. Severity of GBS and polio vaccination his- tory can influence GBS prognosis. Timely treatment and management of GBS, especially severe cases, should be enhanced.