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目的了解无脊髓灰质炎后残留麻痹(含死亡)的急性弛缓性麻痹(AFP)病例的流行病学特征及其影响因素。方法对2000—2012年福建省残留麻痹的AFP病例进行描述流行病学分析,对影响因素进行单因素和多因素非条件logistic回归分析。结果 2000—2012年1822例AFP病例中1790例(98.26%)在麻痹60天后进行了随访,发现残留麻痹病例295例(其中死亡17例),占16.48%。295例残留麻痹病例中,男童是女童的2.13倍,53.22%的病例<2岁;脊灰病毒阳性23例,非脊灰肠道病毒阳性24例。多因素分析显示<1岁发病、免疫史0次和1次、多次就诊、初始麻痹较严重、深部腱反射异常是AFP残留麻痹病例发生的危险因素。结论提高儿童脊髓灰质炎疫苗及时、全程接种率;加强对临床医生培训,及时发现AFP病例,对重症病例及时给予合理治疗,是减少AFP残留麻痹病例发生的相关措施。
Objective To understand the epidemiological characteristics of acute flaccid paralysis (AFP) without polio (including death) and its influencing factors after poliomyelitis. Methods Descriptive epidemiological analysis of AFP cases of residual paralysis in Fujian Province from 2000 to 2012 was conducted, and univariate and multivariate non-conditional logistic regression analyzes were performed on the influencing factors. Results 1790 (98.26%) of 1822 cases of AFP from 2000 to 2012 were followed up 60 days after paralysis. 295 cases of residual paralysis (including 17 deaths) were found, accounting for 16.48%. Among 295 cases of residual paralysis, the number of boys was 2.13 times that of girls, 53.22% of cases were less than 2 years old, 23 cases of poliovirus positive and 24 cases of non-polio enterovirus positive. Multivariate analysis showed that the incidence of <1 year old, immunization 0 times and 1 times, multiple visits, more severe initial paralysis, deep tendon reflex abnormalities is AFP residual paralysis risk factors. Conclusions The timely and full vaccination rate of polio vaccine for children is improved. The training of clinicians, timely detection of AFP cases and timely and reasonable treatment of severe cases are the relevant measures to reduce the occurrence of residual paralysis of AFP.