2004-2007年重庆市急性弛缓性麻痹病例监测结果分析

目的　评价重庆市2004-2007年急性弛缓性麻痹（AFP）病例监测运转情况。方法　按照脊髓灰质炎实验室手册操作规程进行病毒分离与鉴定，由国家脊灰实验室用聚合酶链反应－限制性片段长度多态性分析（PCR RFLP）法和ELISA法对分离到的脊灰病毒株进行型内鉴定。结果　从395例AFP病例粪便标本中分离到脊灰病毒（PV）12株，其中脊灰Ⅰ型 1株，Ⅱ型4株，Ⅲ型4株，PV混合1株，PV+NPEV（非脊灰肠道病毒）混合2株，所有PV经国家脊灰实验室进行型内鉴定，均为疫苗相关株，未发现疫苗衍生脊灰病毒株（VDPV）。分离非脊灰肠道病毒（NPEV）27株。结论　重庆市2004-2007年急性驰缓性麻痹病例中未发现脊灰野病毒和疫苗衍生脊灰病毒（VDPV）株存在，且AFP病例监测系统的各项监测指标都达到控制标准，表明重庆市脊灰实验室监测质量稳定，今后更要继续加强实验室的监测，保持整个监测过程的高度敏感性。

Surveillance results of acute flaccid paralysis in Chongqing from 2004 to 2007

Objective　The study was conducted to evaluate the performance of surveillance on acute flaccid paralysis (AFP) in Chongqing from 2004 to 2007. Methods　The viruses were isolated and identified according to Polio Laboratory Manual. PCR RFLP and ELISA were applied in intratypic differentiation of the isolates by National Poliomyelitis Laboratory. Results　A total of 12 strains of poliovirus (PV) were isolated from the stool samples of 395 AFP patients，including 1 strain of type Ⅰpoliovirus，4 strains of type Ⅱ poliovirus，4 strains of type Ⅲ poliovirus，1 strain of mixed poliovirus and 2 strains of poliovirus mixed with NPEV (non polio enterovirus). All PVs were sent to National Poliomyelitis Laboratory for intratypic differentiation and were subsequently identified as vaccine related strains. No vaccine derived poliovirus（VDPV）were detected. A total of 27 strains of non polio enterovirus were isolated. Conclusion　No wild poliovirus or vaccine derived poliovirus was found in the AFP cases in Chongqing from 2004 to 2007. The performance of AFP surveillance system proved to meet the control requirements, suggesting a stable performance of the poliomyelitis laboratory in Chongqing. Therefore, it is suggested that laboratory surveillance should be strengthened to ensure the high sensitivity of the surveillance.