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目的分析北京市1995~2011年急性弛缓性麻痹(Acute Flaccid Paralysis,AFP)病例肠道病毒(Enterovirus,EV)监测情况。方法对北京市1995~2011年AFP病例分离到的脊髓灰质炎(脊灰)病毒(Poliovirus,PV)和非脊灰(Non-polio)EV(NPEV)进行描述性分析。结果共检测478例AFP病例的967份粪便标本,在90例AFP病例的133份粪便标本中检出EV,分离率为13.75%;其中20例AFP病例的41份粪便标本检出PV(30.83%),70例AFP病例的92份粪便标本检出NPEV(69.17%)。在41份PV阳性标本中,检出PVⅡ型(Type 2)(PVⅡ)11份,PVⅢ型(Type 3)(PVⅢ)10份,分别占单型PV检出总数的40.74%和37.04%。在14例疫苗相关麻痹型脊灰(Vaccineassociated Paralytic Poliomyelitis,VAPP)病例中,PVⅡ和PVⅠ型(Type 1)(PVⅠ)+PVⅡ+PVⅢVAPP病例发病60天后随访均有不同程度的残留麻痹。2007~2008年,在NPEV阳性标本中检出7例14份粪便标本EV71型阳性,1例2份粪便标本柯萨奇病毒A组16型阳性。结论北京市1995~2011年AFP病例中,EV分布主要为NPEV,其次为PV;PVⅡ和PVⅠ+PVⅡ+PVⅢ是引起残留麻痹的主要PV型别;应深入研究EV不同血清型分布及流行规律。
Objective To analyze the surveillance of enterovirus (EV) in Acute Flaccid Paralysis (AFP) in Beijing from 1995 to 2011. Methods Poliovirus (PV) and non-polio EV (NPEV) isolated from AFP cases in Beijing from 1995 to 2011 were analyzed. Results A total of 967 stool specimens from 478 AFP cases were detected. EV was detected in 133 stool specimens of 90 AFP cases, with a separation rate of 13.75%. In 41 stool specimens of 20 AFP cases, PV (30.83% ), NPEV was detected in 92 stool specimens from 70 AFP cases (69.17%). Among 41 PV-positive specimens, 11 PV-Ⅱ and PVⅢ were detected, accounting for 40.74% and 37.04% of the total PV-positive PVs, respectively. Among 14 cases of vaccine-associated paralytic poliomyelitis (VAPP), PVⅡ and PVⅠ + PVⅡ + PVⅢVAPP patients were followed up for varying degrees of residual paralysis after 60 days of onset. From 2007 to 2008, 14 cases of stool specimens were positive for EV71 in positive specimens of NPEV, and 1 specimen of 2 positive specimens for stool specimens in group C of Coxsackie A virus. Conclusions The distribution of EV in Beijing from 1995 to 2011 was mainly NPEV followed by PV. PVⅡ and PVⅠ + PVⅡ + PVⅢ were the major PV types causing residual paralysis. The distribution and prevalence of EV in different serotypes should be studied in depth.