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目的了解河南省急性弛缓性麻痹病例(acute flaccid paralysis,AFP)中残留麻痹儿童的流行病学特征及残留麻痹影响因素。方法描述性分析河南省2008-2012年394例残留麻痹的年龄<15岁的AFP病例,用单因素和多因素Logistic回归分析方法分析影响因素。结果 12.88%的AFP病例残留麻痹,年龄<5岁儿童占73.35%,男女性别比为1.92∶1。肠道病毒分离率为20.81%,病例麻痹部位主要为单下肢、四肢、双下肢。多因素分析结果显示,小年龄麻痹、夏季发病、脊灰疫苗免疫史<3剂次、肠道病毒阳性、四肢麻痹、报告医院级别高是儿童AFP病例残留麻痹的危险因素。结论提高脊灰疫苗接种率、养成良好的卫生习惯、尽早对因对症治疗及康复训练,是降低儿童AFP病例残留麻痹率的有效措施。
Objective To understand the epidemiological characteristics of residual paralysis in children with acute paralysis of acute flaccid paralysis (AFP) in Henan Province. Methods Descriptive analysis of 394 AFP cases of residual paralysis aged <15 years in Henan province from 2008 to 2012 was conducted. The influencing factors were analyzed by single factor and multivariate logistic regression analysis. Results Residual paralysis was found in 12.88% of AFP cases, 73.35% of children <5 years of age, and the sex ratio was 1.92:1. Intestinal virus isolation rate was 20.81%, paralysis cases mainly single lower limbs, limbs, both lower extremities. Multivariate analysis showed that small age paralysis, summer onset, history of polio vaccine immunization <3, positive enterovirus, paralysis of the limbs, and high hospital-level reports were risk factors for residual paralysis in children with AFP. Conclusions Increasing polio vaccination rate and developing good hygiene habits are effective measures to reduce the residual paralytic rate of AFP cases in children as early as possible due to symptomatic treatment and rehabilitation training.