山东省急性弛缓性麻痹病例非脊髓灰质炎肠道病毒感染监测分析

An Analysis on Surveillance of the Non-polio Enteroviruses Infection among Acute Flaccid Paralysis Cases in Shandong Province

[目的 ]了解山东省急性弛缓性麻痹 (AFP)病例非脊灰肠道病毒 (NPEV)的感染情况。 [方法 ]按照WHO规定的方法 ,对山东省 1 998～2 0 0 1年所有AFP病例的大便标本均采用RD、Hep 2和L2 0B细胞进行病毒分离鉴定。 [结果 ]共分离出 1 4 6株NPEV ,其中艾柯 (Echo)病毒占 56 1 6 % ,病毒型别分布广泛 ,夏秋季为NPEV流行高峰 ;5岁以下儿童分离率最高 ;多数NPEV感染者麻痹前均伴有发热、腹泻、颈项强直和肌肉疼痛 ,麻痹部位以单下肢、双下肢、四肢麻痹为主 ,发病60d后随访 2 7 40 %的病例仍残留麻痹 ;1 4 6例NPEV阳性的AFP病例中 ,疫苗相关病例 (VAPP) 1例 ,格林巴利综合征(GBS) 60例 ,脑脊髓炎 1 0例 ,其他非脊灰病例 75例 ;RD细胞对NPEV的分离率高于Hep 2细胞的分离率。 [结论 ]NPEV在山东省AFP病例中具有较高的感染率 。

Objective\]To explore the non polio enteroviruses (NPEV) infection situation among acute flaccid paralysis (AFP) cases in Shandong province \All stool specimens from AFP cases during 1998～2001 were isolated and identified with L20B, RD and Hep 2 cells according to the WHO standard method \146 NPEV strains were isolated from AFP cases,56 16% were echovirus, with the types of virus widely distributed, reaching the peak in summer and autumn; the rate of isolation was the highest among children under 5; Most AFP cases infected by NPEV had fever, diarrhea or other symptoms and signs before paralysis , with the locations of paralysis especially in the single leg, the two legs and the four limbs, 27 40% had residual paralysis after 60 days by follow up investigation Among 146 NPEV positive AFP cases, 1 case with VAPP, 60 cases with Guillain Barre syndrome , 10 cases with encephalomyelitis, and 75 non polio cases; The NPEV isolation rates with RD cells were significantly higher than that with Hep 2 cells \[Conclusions\]The NPEV infection rate is high among AFP cases in Shandong Province The etiological study should be strengthened on the relationship between the NPEV infection and AFP cases in the future