西藏自治区改则县棘球蚴病流行情况调查  

Epidemiological survey of echinococcosis in Gaize County,Tibet Autonomous Region

作　　者：罗钊辉 肖丹 艾佳佳 庞华胜 李景中[1] 秋尼措姆 张颋 陈家旭 LUO Zhao-hui;XIAO Dan;AI Jia-jia;PANG Hua-sheng;LI Jing-zhong;Qiunicuomu;ZHANG Ting;CHEN Jia-xu(Tibet Autonomous Region Center for Disease Control and Prevention,National Health Commission Key Laboratory of Echinococcosis Prevention and Control,Lhasa 850000,China;Gaize County for Disease Control and Prevention,Ali 859200,China;National Institute of Parasitic Diseases,Chinese Center for Disease Control and Prevention(Chinese Center for Tropical Diseases Research),NHC Key Laboratory of Parasite and Vector Biology,WHO Collaborating Center for Tropical Diseases,National Center for International Research on Tropical Diseases,Shanghai 200025,China)

机构地区：[1]西藏自治区疾病预防控制中心,国家卫生健康委员会包虫病防治研究重点实验室,拉萨850000 [2]西藏自治区改则县疾病预防控制中心,阿里859200 [3]中国疾病预防控制中心寄生虫病预防控制所(国家热带病研究中心),国家卫生健康委员会寄生虫病原与媒介生物学重点实验室,世界卫生组织热带病合作中心,国家级热带病国际联合研究中心,上海200025

出　　处：《中国人兽共患病学报》2022年第1期74-78,共5页Chinese Journal of Zoonoses

基　　金：中国医学科学院中央级公益性科研院所基本科研业务费专项资金(No.2019PT320004)。

摘　　要：目的了解西藏自治区改则县棘球蚴病流行状况,为防治提供依据。方法2017年6-11月采取普查的方式,对改则县所辖7个乡镇的2岁以上常住居民进行腹部B超检查,对疑似病例进行血清中棘球蚴IgG抗体检测,计算人群棘球蚴病患病率。并在改则镇、麻米乡和物玛乡采集犬粪,采用ELISA检测棘球绦虫抗原。结果B超共检查21376人,发现棘球蚴病患者353例,改则县人群棘球蚴病患病率为1.65%(353/21376)。改则县7个乡(镇)均有棘球蚴病流行,其中,以古姆乡人群患病率最高,为2.28%(54/2369);最低的先遣乡为0.76%(13/1716),各乡之间的患病率差异有显著性(χ^(2)=25.891,P<0.05)。女性患病率为1.97%(205/10410)高于男性的1.35%(148/10966)(χ^(2)=12.625,P<0.05)。不同年龄组间患病率随年龄增长而升高(χ^(2)=346.854,P<0.05),70岁以上人群最高为6.85%(49/715),10岁以下儿童最低为0.24%(12/4908)。各民族中,藏族患病率(1.67%,353/21084)高于汉族和回族总和(0,0/292),差异有统计学意义(P=0.017)。不同职业人群间患病检出率差异有统计学意义(χ^(2)=10.324,P=0.035),其中牧民患病率最高,为1.78%(296/16614);所发现病例中,处于活跃及过渡期(CE1-3)的病灶占52.69%(186/353),处于钙化期的(CE4-5)占45.04%(159/353)。调查发现家犬和无主犬棘球绦虫粪抗原阳性率分别为20.00%(9/45)和17.65%(6/34),两者差异无统计学意义(χ^(2)=0.070,P=0.792)。结论改则县7个乡均存在较高程度的棘球蚴病流行,以古姆乡最高。女性、藏族、牧民和60岁以上人群是重点防治对象。家犬和野犬均需纳入传染源防控。This study investigated the prevalence of echinococcosis in Gaize County,Tibet Autonomous Region,to provide a reference for its prevention and control.From June to November 2017,an epidemiological survey was conducted in seven townships of Gaize County.Residents over 2years of age were examined with abdominal B-ultrasound,and suspected cases were confirmed through serological testing.The prevalence of echinococcosis in the local area was calculated.In addition,Echinococcus antigen in dog feces collected in the towns of Gaize,Mami and Wuma was examined by ELISA.A total of 21376 residents received B-ultrasound,of whom 353showed echinococcosis.The prevalence of echinococcosis in Gaize county was 1.65%(353/21,376).The seven townships in Gaize County were all found to have echinococcosis;among them,the prevalence was highest in Gumu(2.28%,54/2369)and lowest in Xianqian(0.76%,13/1716),and a significant difference was observed among the townships(χ^(2)=25.881,P<0.05).The prevalence in females was 1.97%(205/10410),a value significantly higher than that in males(1.35%,148/10966)(χ^(2)=12.625,P<0.05).A significant difference by age(χ^(2)=346.854,P<0.05)was also observed,with the highest prevalence in the group≥70years of age(6.85%,49/715),and the lowest in the group of<10years of age(0.24%,12/4908).Overall,the prevalence showed a trend of increasing with age.The prevalence in people of Tibetan ethnicity(1.67%,353/21084)was higher than that in people of Han and Hui ethnicity combined(0,0/292),and the difference was significant(P=0.017).The prevalence varied significantly among residents with different occupations(χ^(2)=10.324,P=0.035),with herders ranking first(1.78%,296/16614).Among the cases identified,52.69%(186/353)were in the active or transitional stage(CE1-3),and 45.04%(159/353)were in the inactive stage(CE4-5).No significant difference was found between the positivity rates of copro-antigen of Echinococcus in domestic dog feces(20.00%,9/45)and stray dog feces(17.65%,6/34)(χ^(2)=0.070,P=0.792).Echinococcosis w

关 键 词：棘球蚴病 流行病学调查 西藏自治区 改则县 

分 类 号：R383.33[医药卫生—医学寄生虫学]