摘要
目的了解和掌握青海省人体棘球蚴病流行与分布情况。方法于2012年3-9月在青海省43个县(市、区)按牧区、半农牧区、农区和城镇进行分层,根据各层人口数占全县(市、区)人口总数的比例确定各层调查人数及调查村数,对3周岁以上常住居民进行B超检查,开展人群棘球蚴患病情况调查;每层抽取1所小学,或者在学校集中的县城抽取全县所有小学,对6~13岁学生进行腹腔B超检查,同时采集静脉血,用ELISA试剂盒检测血清抗棘球蚴Ig G抗体水平。应用SPSS17.0软件对调查结果进行统计学分析,计算患病检出率和血清抗体阳性率,率间的比较采用χ~2检验。结果青海省43个县(市、区)共抽取683个行政村(社区),B超检查121 683人,检出棘球蚴病患者1 333例,平均患病检出率为1.10%(1 333/121 683)。人群调查结果显示,不同生产类型的牧区、半农牧区、农区、城镇的患病检出率依次为2.51%(1 101/43 822)、0.84%(111/13 228)、0.08%(30/38 882)和0.35%(91/25 751)。性别分布中,男、女患病检出率分别为0.90%(526/58 348)、1.27%(807/63 335),差异有统计学意义(χ~2=38.93,P<0.01);年龄分布中,以30~39岁青壮年人群患病检出率最高,为1.51%(387/25 682),不同年龄组间患病检出率差异有统计学意义(χ~2=80.84,P<0.01);调查对象来自于14个民族,其中1 333例患者主要分布于藏族、汉族、回族、蒙古族和撒拉族,这5个民族的患病检出率分别为2.25%(1 277/56 752)、0.07%(32/44 420)、0.01%(1/8 229)、0.25%(17/6 806)和0.04%(1/2 558),各民族患病检出率间差异有统计学意义(χ~2=1 354.77,P<0.01);职业分布中以宗教人士的患病检出率最高,为5.08%(52/1 024),牧民次之,为2.42%(1 089/44 982)。共抽取小学191所,均来自学校集中的县城,B超检查学生47 747人,检出棘球蚴病者253例,平均患病检出率为0.53%(253/47 747);ELISA检测45 507份血清,阳性者2 693份,血清抗体阳性率为5.92%。结论青海南部各县是棘球蚴病流行严重的地区。
Objective To understand the endemic situation and distribution of echinococcosis in Qinghai Province. Methods Stratified random sampling was performed in 43 counties/cities/districts in Qinghai Province from March to September in 2012, according to pastoral area, pastoral-agricuhural area, agricuhural area, and township area. The numbers of individuals and villages for survey in each kind of area were determined based on the proportions of total number of residents in each area to the total number in the county/city/district. B ultrasound examination was performed on residents aged over 3. B ultrasound was performed among students of 6-13 years in one primary school selected from each kind of area, or in all the primary schools from the school-enriched counties. Venous blood was also collected to detect serum level of anti-echinococcus IgG by ELISA. The results were statistically analyzed using SPSS17.0 software. The detection rate of echinococcosis and positive rate of serum IgG were calculated and analyzed with chi-square test using SPSS17.0 software. Results A total of 683 villages/ communities were selected from the 43 counties/cities/districts. B ultrasound was performed on 121 683 participants, of whom 1 333 were positive for echinococcosis （morbidity rate, 1.10%）. The morbidity rates in the pastoral area, pastoral-agricultural area, agricultural area, and township area were 2.51% （1 101/43 822）, 0.84% （111/13 228）, 0.08% （30/38 882） and 0.35% （91/25 751）, respectively. There was a significant difference of the morbidity rate between males （0.90%, 526/58 348） and females （1.27%, 807/63 335）0（2 = 38.93, P 〈 0.01）. There was also a significant difference in the morbidity rate among different age groups（X^2= 80.84, P〈0.01）, with the highest rate being in the 30- 39 years（1.51%, 387/25 682）. The participants were of 14 ethnicities. Of them 1 333 were positive for echinococcosis, mainly from five ethnicities, the Tibetan （morbidity rate, 2.25%, 1 277/56 752）, Han （0.07%, 32/44 420）, Hui （0.01%, 1/8229）, Mogol （0.25%, 17/6 806） and Sala ethnicity （0.04%, 1/2 558）. There was a significant difference in the morbidity rate among the ethnicities （.X^2= 1 354.77, P 〈 0.01）. Among occupations, the religious people had the highest morbidity rate （5.08%, 52/1 024）, followed by herdsmen （2.42%, 1 089/44 981）. A total of 191 primary schools, all from the county towns, were selected, and 47 747 students aged 6-13 years were examined by ultrasonography, of whom 253 were detected to be positive for echinococcosis, with a morbidity rate of 0.53% （253/47 747）. ELISA results showed that 2 693 of 45 507 students were positive for serum anti-echinococcus IgG, with a positive rate of 5.92%. Conclusion There is a serious endemic situation of echinococcosis in counties of southern Qinghai.
出处
《中国寄生虫学与寄生虫病杂志》
CAS
CSCD
北大核心
2017年第5期460-465,共6页
Chinese Journal of Parasitology and Parasitic Diseases
