2013-2020年河南省急性弛缓性麻痹病例中残留麻痹病例的流行病学特征及影响因素

Epidemiological characteristics and risk factors of acute flaccid paralysis cases with residual paralysis in Henan in 2013-2020

目的分析2013-2020年河南省急性弛缓性麻痹(acute flaccid paralysis,AFP)病例中残留麻痹者的流行病学特征,为减少疾病负担,制定科学的防控策略提供理论依据。方法对2013-2020年河南省AFP病例中残留麻痹者个案调查资料进行描述流行病学分析,采用Logistic回归分析残留麻痹的影响因素。结果AFP病例残留麻痹率为9.57%(389/4066);其中,五岁以下儿童(56.30%,219/389)、秋季发病(31.36%,122/389)、男性(58.35%,227/389)病例比例较高;肠道病毒分离率为10.80%(42/389)。多因素Logistic回归分析显示,麻痹年龄<1岁、发热、肢体感觉障碍、深部腱反射减弱或消失、脊灰疫苗免疫史<3次、四肢麻痹为AFP病例残留麻痹的危险因素。其中脊灰疫苗免疫史<3次发生残留麻痹的风险是≥3次的3.093倍,麻痹部位发生为四肢者残留麻痹的风险是其它病例的3.654倍。结论应针对高风险病例及时采取有效措施,尽早对因对症治疗,从而降低AFP病例残留麻痹率。

Objective To analyze the epidemiological characteristics of acute flaccid paralysis(AFP)cases with residual paralysis in Henan from 2013-2020,and provide theoretical basis for reducing disease burden and formulating scientific prevention and control strategies.Methods Descriptive epidemiological analysis was conducted on the investigation data of AFP cases with residual paralysis in Henan province from 2013 to 2020,and the influencing factors of residual paralysis were analyzed by Logistic regression.Results The residual paralysis rate of AFP cases was 9.57%(389/4066),of which the proportion of cases under 5years old(56.30%,219/389),occurring in autumn(31.36%,122/389),and male(58.35%,227/389)was higher.The isolation rate of enterovirus was 10.80%(42/389).Multivariate Logistic regression analysis showed that paralysis age<1 year,fever,limb sensory disturbance,weakened or disappeared deep tendon reflex,polio vaccine immunization history<3 times,and quadriplegia were the risk factors for residual paralysis in AFP cases.The risk of residual paralysis with polio vaccine immunization history<3 times was 3.093 times higher than≥3 times,and the risk of residual paralysis with paralysis site and limbs was 3.654times higher than other cases.Conclusion Effective measures should be taken in time for high-risk cases,and symptomatic treatment should be taken as soon as possible so as to reduce the residual paralysis rate of AFP cases.