在消灭脊髓灰质炎（脊灰）的最后阶段，如何根据临床信息尽早发现高危脊灰病例，以便采取针对性措施，阻断野病毒的流行是一个值得探讨的问题。山东省资料表明，用＜５岁、麻痹伴发热、肌力＜３级、腱反射减弱４个因素并综合考虑免疫史因素，作为高危脊灰病例早期临床筛检指标，可达到较高的敏感性和特异性。在晚期病例诊断中，＜５岁、６０天残留麻痹、腱反射减弱或消失作为临床符合病例的诊断指标，既满足了高敏感性，又达到了较高特异性。在各级医院诊断特异性和阳性预测值不高的情况下，更加表明需要用临床指标进行筛检的重要性 In the final stage of eradication of poliomyelitis (polio), how to detect high-risk polio cases as soon as possible based on clinical information so that targeted measures can be taken to block the spread of wild virus is a question worth exploring. Shandong Province data show that with <5 years of age, paralysis with fever, muscle strength <3, decreased tendon reflex 4 factors and comprehensive consideration of immunosuppressive factors, as high-risk polio cases early clinical screening indicators can reach a higher sensitivity Sexual and specific. In the diagnosis of advanced cases, <5 years old, 60 days residual paralysis, tendon reflexes disappear or disappear as a clinical diagnostic criteria for the case, both to meet the high sensitivity, but also achieved a high specificity. The diagnostic specificity and positive predictive value of hospitals at all levels is not high, the need to screen the importance of clinical indicators