华南预防医学 ›› 2013, Vol. 39 ›› Issue (4): 11-14.doi: 10.13217/j.scjpm.2013.04.011

• 论著 • 上一篇    下一篇

2008—2012年广东省残留麻痹的急性弛缓性麻痹病例流行病学特征及影响因素分析

谭秋, 郑慧贞, 朱琦, 韩轲, 刘宇, 刘楚钿   

  1. 广东省疾病预防控制中心,广东 广州 511430
  • 收稿日期:2013-03-26 出版日期:2013-08-20 发布日期:2013-12-23
  • 作者简介:谭秋(1981—),女,硕士,主管医师,主要从事免疫规划管理工作

Correlative risk factors of residual paralysis among acute flaccid paralysis cases in Guangdong Province,2008-2012

TAN Qiu, ZHENG Hui-zhen, ZHU Qi, HAN Ke, LIU Yu, LIU Chu-tian   

  1. Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
  • Received:2013-03-26 Online:2013-08-20 Published:2013-12-23

摘要: 目的分析广东省残留麻痹的急性弛缓性麻痹(AFP)病例的流行病学特征及影响因素,探究预防措施。方法病例资料来自2008—2012年广东省AFP病例监测系统。病例资料包括病例基本情况、临床症状和体征、麻痹后就诊、免疫接种等情况,并采集双份粪便送省脊灰实验室检测。对残留麻痹AFP病例进行描述性流行病学分析,对残留麻痹的有关影响因素作单因素和多因素非条件logistic回归分析。结果广东省2008—2012年共报告1 659例AFP病例,其中231例残留麻痹,占13.92%。残留麻痹病例集中分布于0~4岁,占82.25%(190/231),接种3剂次及以上脊髓灰质炎(脊灰)疫苗者占67.97%(157/231),麻痹前多有发热症状(占71.43%,165/231),以下肢麻痹多见(占67.10%,155/231),粪便标本脊灰病毒分离率为19.82%(45/227)。经多因素回归分析,女性、麻痹前发热、粪便分离出脊灰病毒是使AFP病例残留麻痹风险升高的因素, OR值分别为1.673、1.560、6.535;脊灰疫苗免疫3次以上、发病年龄较大是使AFP病例残留麻痹率降低的因素, OR值分别为0.505、0.570。结论粪便分离出脊灰病毒使AFP病例残留麻痹风险显著升高,残留麻痹病例中可能存在部分脊灰疫苗相关病例,加强对残留麻痹的AFP病例的临床诊断,有利于明确残留麻痹中可能存在的脊灰疫苗相关病例,进而采取防控措施。提高脊灰疫苗接种率,有利于减少AFP病例残留麻痹的发生。

Abstract: Objective To analyze epidemiological characteristics and correlative risk factors of sequela of paralysis in acute flaccid paralysis (AFP) cases in Guangdong Province and to explore relevant prevention and control measures.Methods The data of the cases were from AFP surveillance system of Guangdong Province and included basic situation, clinical symptom, doctor visits, history of immunization. Specimens of double feces were collected and delivered to provincial laboratory to detect polio virus. Descriptive epidemiological method was used to analyze the epidemiological characteristics of AFP cases with residual paralysis during 2008 to 2012. The correlative risk factors of sequela of paralysis were analyzed with univariate and multivariate non-conditional logistic regression. Results A total of 1 659 AFP cases were reported, including 231 cases of residual paralysis (13.92%) in Guangdong Province from 2008 to 2012. The residual paralysis cases concentrated in the children aged 0-4 years old (82.25%, 190/231). 67.97% of the residual paralysis cases had been vaccinated at least 3 times. Before paralysis, the most symptoms of the residual paralysis cases were fever (71.43%, 165/231) and lower limb paralysis (67.10%, 155/231). The polio virus isolating rate from the excrement of residual paralysis cases was 19.82% (45/227). The multivariate nonconditional logistic regression analyses showed that residual paralysis of AFP cases was associated with female, fever before paralysis, and polio virus isolated from the faces specimen with OR at 1.673, 1.560, and 6.535, respectively. Conclusion The polio virus isolated from feces significantly increased risk of residual paralysis of AFP cases. Cases of vaccine associated paralytic poliomyelitis may exist among residual paralysis cases. A high immunization coverage rate should be promoted to reduce the incidence of residual paralysis in AFP cases.

中图分类号: 

  • R512.4