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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 understand the epidemiological characteristics of Guillain-Barre syndrome (GBS) in children aged 15 years and less in China (excluding Hong Kong, Macao Special Administrative Region and Taiwan, the same below) and to explore the factors influencing GBS residual paralysis. Methods Descriptive epidemiological methods were used to analyze GBS case data of children <15 years old in China collected from the Acute flaccid paralysis (AFP) case monitoring information report management system. Results A total of 931 GBS cases of children aged <15 years were reported in China in 2014, with a reported incidence of 0.41 / 100,000. GBS had muscle pain, paralysis of the limbs, decreased or disappeared deep tendon reflexes, sensory disturbances and residual paralysis were significantly higher than other AFP cases. Poliomyelitis (polio) vaccine immunization history <3 times, with neck stiffness and limb paralysis, degree of paralysis and deep tendon reflex interaction as a risk factor for GBS paralysis. Conclusions The incidence of GBS in children <15 years old in China is low. The severity of the disease and the immunization history of polio vaccine affect the prognosis of GBS. The timely treatment and management of GBS, especially serious cases, should be strengthened.