摘要
“脊髓灰质炎”(简称脊灰)是由脊灰病毒引起的一种急性肠道传染病,疫苗免疫预防是控制乃至消灭脊灰最重要的策略。世界卫生组织(WHO)推荐用于全球消灭脊灰的主导疫苗是口服脊髓灰质炎减毒活疫苗(OPV)。OPV在安全性方面存在一定问题:服用OPV可能引起麻痹型病例,即疫苗相关病例(vaccine-associated paralytic poliomyelitis,VAPP)。目前除了非洲以外,各大洲均有关于VAPP发生的报道。20世纪90年代以来,我国有近20个省、市、自治区报告发生了VAPP病例。WHO1970-1979年对6个国家的VAPP进行研究,发病率为0.07/100万,其中55%为Ⅲ型相关病例,38%为Ⅱ型相关病例,Ⅰ型的仅为7%,服苗病例主要由Ⅲ型疫苗病毒引起,接触病例中Ⅱ型疫苗病毒多见。VAPP发病机制主要有病毒基因突变、病毒基因重组、免疫缺陷等。消灭脊髓灰质炎以后是否应停止脊灰疫苗免疫并以此作为全球消灭脊灰的最终目标是全球专家正在讨论的问题。
“Poliomyelitis”（abbreviated as polio）is a kind of acute intestinal pandemic caused by poliovirus. Vaccine immunity prevention is the most important strategy of controlling and even eliminating polio. OPV（oral polio vaccine）is the leading vaccine used in global elimination recommend by World Health Organization（WHO）. There are certain problems about the safety of OPV i.e. OPV may cause paralytic case that is vaccine-associated paralytic poliomyelitis（VAPP）. Except Africa, the other continents have reported VAPP. Since the 1990s, there were nearly 20 provinces reported VAPP cases in China. The study of 6 countries by WHO showed the incidence rate was 0.07/10^6, of which 55% was Sabin Ⅲ, 38% related to Sabin Ⅱ, Sabin I was only 7%. Oral vaccine cases were caused mainly by Sabin Ⅲ, and contact cases were caused mainly by Sabin Ⅱ. The pathogenesis of VAPP mainly includes viral genetic mutation, viral genetic recombination and immunity defect, etc. Whether OPV immunity should be stopped or not and whether to make it as the end-all after elimination of polio around the world or not, are the problems that global experts are discussing.
出处
《预防医学情报杂志》
CAS
2007年第4期436-440,共5页
Journal of Preventive Medicine Information
