中国2009年脊髓灰质炎实验室网络的运转情况与评价  

Running Status and Evaluation of Chinese Polio Laboratories Network in 2009

作　　者：祝双利[1] 张勇[1] 严冬梅[1] 朱晖[1] 王东艳[1] 安军静[1] 安洪秋[1] 檀晓娟[1] 陈立[1] 许文波[1] 

机构地区：[1]中国疾病预防控制中心病毒病预防控制所,世界卫生组织西太平洋区脊髓灰质炎参比实验室,北京102206

出　　处：《中国疫苗和免疫》2013年第3期204-209,239,共7页Chinese Journal of Vaccines and Immunization

基　　金：卫生部2009年疾病预防控制专项;科学技术部维持无脊髓灰质炎时期外环境脊髓灰质炎病毒检测技术的建立及推广应用(编号2008BA156B02);科学技术部艾滋病和病毒性肝炎等重大传染病防治科学技术重大专项病原体网络化监测技术研究课题重要病毒的环境标本检测技术研究子课题(编号2008ZX10004-008)

摘　　要：目的通过对2009年中国(未包括香港、澳门特别行政区和台湾地区,下同)脊髓灰质炎(脊灰)实验室网络(Polio Laboratory Network,PLN)监测数据进行分析,评估其运转情况,为中国维持无脊灰状态提供病毒学依据。方法分析中国免疫规划监测信息管理系统数据库中,31个省(自治区、直辖市,下同)上报的急性弛缓性麻痹(Acute Flaccid Paralysis,AFP)病例个案调查表和中国疾病预防控制中心(Center for Disease Control and Prevention,CDC)病毒病预防控制所国家脊灰实验室(National Polio Laboratory,NPL)的监测数据库,评价PLN的各项运转指标。结果 2009年全国PLN共收集了4829例AFP病例的9621份粪便标本,14d内双份粪便标本采集率为90.8%,合格粪便标本采集率为90.0%。按世界卫生组织(World Health Organization,WHO)第4版《脊灰实验室手册》的要求进行病毒分离和鉴定,试验结果28d内及时反馈率为95.4%。2009年从158例AFP病例中分离到脊灰病毒(Poliovirus,PV),分离率为3.29%;607例分离到非脊灰肠道病毒(Non-polio Enterovirus,NPEV),分离率为12.63%。2009年,NPL收到PLN送检的214株PV阳性分离物,对284株单血清型PV采用VP1编码区核苷酸序列测定与分析的方法进行型内鉴定,发现1株Ⅱ型疫苗衍生脊灰病毒,未发现脊灰野病毒。2009年,NPL以优异的成绩通过了WHO盲样标本的能力验证和现场认证考核;31个省级CDC脊灰实验室通过了与NPL相同的盲样标本的能力验证;12个省级CDC脊灰实验室通过了WHO的实验室现场评估考核。结论 2009年,PLN运转正常、敏感有效,为维持无脊灰状态提供了病毒学依据,中国继续保持无脊灰状态。Objective Inorder to evaluate the running status and provide the laboratory data for maintaining polio-free status in China,the virological surveillance database of Chinese polio laboratories network （PLN ;not include Hong Kong Special Administrative Region,Macao Special Administrative Region,and Taiwan Sheng） in 2009 were analyzed.Methods The case investigation data of acute flaccid paralysis （AFP） cases reported by 31 provinces （municipalities,autonomous regions） through expanded programme on immunization surveillance information management system and the database of national polio laboratory （NPL） were analyzed,and the indicators of running status of Chinese PLN were evaluated.Results 9621 stool samples were collected from 4829 AFP cases by Chinese PLN in 2009,and identification according to 4 th World Health Organization （WHO） polio laboratory manual,the rate of viral isolation and identification performed within 28d was 95.4 % .There are 158 polioviruses （PV） and 607 of non-polio enteroviruses （NPEV） were isolated from AFP cases,the isolation rates were3.29 % and12.63 % respectively.214 polio positive isolates were sent to NPL by 31 provincial polio laboratories.Protocol for intratypic differentitation in NPL was VP1 sequencing.There were 284 single serotype PVs were performed VP1 sequencing,there is 1 vaccine-derived polioviruses （VDPVs） and no wild PVs were found in 2009.NPL got full scores and passed the proficiency test and got full accreditation for on-site review by WHO experts in 2009.All 31 provincial polio laboratories passed the proficiency test with the same panel as NPL,they all got full scores.13 provincial polio laboratories joined and passed the on-site review by WHO experts.Conclusion The running status of Chinese PLN was good,polio-free status was maintained in China in 2009;the Chinese PLN ran normally,the laboratory surveillance system was sensitive and laboratory data were provided reference for maintaining the polio-free status in China.

关 键 词：脊髓灰质炎实验室网络 运转 评价 

分 类 号：R563.1[医药卫生—呼吸系统]