北京市1995-2011年急性弛缓性麻痹病例肠道病毒监测分析

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。

Analysis of Enterovirus Surveillance on Acute Flaccid Paralysis Cases in BeiJing from 1995-2011

Objective To analysis the results of surveillance of enterovirus （EV） for the acute flaccid paralysis （AFP） in Beijing during 1995-2011. Methods Isolating and identifying poliovirus （PV）and Non-polio EV （NPEV）from AFP cases during 1995-2011 are described and analysed. Results 967 stool samples from 478 AFP cases were tested and 133 EV were isolated from 90 AFP cases, the isolation rate was 13.75%. 41 stool samples from 20 AFP cases found PV and 92 stool samples from 70 AFP cases found NPEV. The detection rate of PV and NPEV were 30.83% and 69. 17% respectively. 11 PV Type 2 （PVH ） and 10 PV Type 3 （PVm ） were isolated from 41 samples of PV positive stool samples which account for 40.74% and 37.04% respectively of detection number of the PVI ＋ PV~ ＋ PVm; In 14 cases vaccine associated paralytic poliomyelitis （VAPP）, PVH and PVI ＋ PVI ＋ PVm cases remain disability after sixty days paralysis; Fourteen positive samples from seven AFP cases and two samples from one AFP cases were isolated type 16, A group of coxsackie virus （CV） EVT1 during 2007-2008. Conclusions The NPEV was the main part of EV in type16, A group （CVA16） from 1995-2011, and second was PV. Disability after 60 days Paralysis was caused mainly by PVn and PVI ＋ PVI~ ＋ PVm serotypes. The prevalent and the distribution of different serotypes of EV should be studied continuously.