洞庭湖区流动渔民血吸虫病流行病学评估  

Epidemiological evaluation of schistosomiasis in migrant fishermen in Dongting Lake region

作　　者：周杰[1,2] 黄翠云[2,3] 何永康[2] 杜奕奇[4] 喻鑫玲[2] 王媛园[2] 李岳生[2,5] 

机构地区：[1]中南大学公共卫生学院,长沙410005 [2]湖南省血吸虫病防治所 [3]广东省中医院 [4]上海长海医院 [5]澳大利亚昆士兰医学研究所

出　　处：《中国血吸虫病防治杂志》2010年第5期464-467,共4页Chinese Journal of Schistosomiasis Control

基　　金：国家自然科学基金(30671841);湖南省科技厅项目(2009JT1019)

摘　　要：目的评估洞庭湖区水上流动渔民血吸虫病流行病学现状,为制定防治对策提供科学依据。方法在东洞庭湖区随机抽查275例水上流动渔民,进行基本资料调查及粪检,同时在所调查人群中随机抽取129例进行B超检查,所得结果与2001年所调查的同一目标人群资料进行比较,以评估当前流动渔民血吸虫病流行现状。结果本次调查水上流动渔民血吸虫感染率为40.4%,标化后为53.8%,几何均数感染度为17.4±4.4,两者均低于2001年调查结果。B超显示肝脾受损仍然严重,其中肝脏声像呈网状结构的占58.1%(75/129),肝实质纤维化分级达到Ⅱ级以上的为58.9%(76/129),脾肿大率为50.4%(65/129),均高于2001年调查结果(P均<0.01);但肝肿大率38.0%(49/129)及门静脉内径增大率10.1%(13/129)低于2001年调查结果(P均<0.05)。同时B超结果显示肝实质受损男性仍然高于女性(P<0.01)。结论水上流动渔民血吸虫感染率、感染度与2001年相比虽然有所下降,但感染率及感染度仍然较高,且肝脾损伤仍然严重。渔民仍然是重要的血吸虫病传染源,要进一步加强防控措施。Objective To evaluate schistosomiasis endemic status of migrant fishermen in Dongting Lake region so as to provide the evidence for schistosomiasis control.MethodsIn 2009,a total of 275 migrant fishermen in the eastern Dongting Lake region were randomly selected and investigated,their basic information were collected and stool samples were examined for schistosome eggs.Afterward,129 cases from the whole were randomly selected and examined with B-type ultrasound.All the results were compared with the corresponding results got from the same population in 2001.ResultsThe schistosome infection rate of the survey was 40.4%,the standardized infection rate was 53.8%,the infection density（Geo-EPG） was 17.4±4.4,and all of them were lower than the results of the survey in 2001.The results of B-type ultrasound examination showed that the damages in the liver and spleen were still severe,of which,the rate of the schistosomiasis characteristic reticular structure of the liver was 58.1%（75/129）,the rate of the liver parenchyma fibrosis（Ⅱ-Ⅲ degree） was 58.9%（76/129）,the rate of splenomegaly was 50.4%（65/129）,and they were higher than the corresponding results in 2001（P0.01）.However,the rates of hepatomegaly and portal expansion were 38.0% and 10.1%,respectively,and they were lower than those of the survey in 2001（P0.05）.The difference in liver parenchyma between male and female still existed（P0.01）.ConclusionsThough the schistosome infection rate and infection density of the fishermen in 2009 are lower than those of the survey in 2001,they are still high,and the damages in liver and spleen are still severe.The fishermen are still the important source of infection,and we should reinforce the control measures in the population.

关 键 词：血吸虫病 流动渔民 B超 洞庭湖区 流行病学评估 

分 类 号：R532.21[医药卫生—内科学]