我国棘球蚴病疾病负担分析

中国寄生虫学与寄生虫病杂志 ›› 2018, Vol. 36 ›› Issue (1): 15-20.

我国棘球蚴病疾病负担分析

张梦媛^1,², 伍卫平^2,^*(), 官亚宜², 王立英², 侯岩岩³, 冯宇⁴, 马俊英⁵, 王谦⁶, 王莹², 韩帅², 薛垂召², 吴文婷²

1 上海龙华医院,上海 200032
2 中国疾病预防控制中心寄生虫病预防控制所,世界卫生组织热带病合作中心,科技部国家级热带病国际联合研究中心,卫生部寄生虫病原与媒介生物学重点实验室,上海 200025
3 新疆维吾尔自治区疾病预防控制中心,乌鲁木齐 830002
4 甘肃省疾病预防控制中心,兰州 730000
5 青海省地方病预防控制所,西宁 810000
6 四川省疾病预防控制中心,成都 610041

收稿日期:2017-12-29 出版日期:2018-02-28 发布日期:2018-03-14
通讯作者: 伍卫平

Analysis on disease burden of hydatid disease in China

Meng-yuan ZHANG^1,², Wei-ping WU^2,^*(), Ya-yi GUAN², Li-ying WANG², Yan-yan HOU³, Yu FENG⁴, Jun-ying MA⁵, Qian WANG⁶, Ying WANG², Shuai HAN², Chui-zhao XUE², Wen-ting WU²

1 Shanghai Longhua Hospital, Shanghai 200032, China
2 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai 200025, China
3 The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumuqi 830002, China
4 Center for Disease Control and Prevention of Gansu Province, Lanzhou 730000, China
5 Qinghai Provincial Institute of Endemic Disease, Xining 810000, China
6 Center for Disease Control and Prevention of Sichuan Province, Chengdu 610041, China

Received:2017-12-29 Online:2018-02-28 Published:2018-03-14
Contact: Wei-ping WU

摘要/Abstract

摘要：

目的了解棘球蚴病的伤残权重,推算我国棘球蚴病的疾病负担。方法于2016年12月-2017年3月,在甘肃、青海、四川、新疆等4个省（自治区）各选取1家棘球蚴病定点医院,调查1个月内的所有棘球蚴病住院病例;每个省（自治区）抽取2个棘球蚴病流行县,每个县抽取25例棘球蚴病病例,共计200例。根据《国际功能、伤残健康分类》和健康调查简表SF-36,编制棘球蚴病患者生命质量调查表,对患者的生存质量进行调查。分析棘球蚴病患者的生存质量和伤残权重,根据我国棘球蚴病的患病率、现患人数、不同严重程度的伤残权重和人口学资料,计算棘球蚴病的疾病负担,采用SPSS19.0统计学软件对患者的生存质量、疾病严重程度进行参数检验和非参数检验。结果从甘肃、青海、四川、新疆等4个省（自治区）分别收到调查问卷76、95、79、89份,共339份;有效问卷分别为76、91、79、88份,共334份,问卷有效回收率为98.53%（334/339）。男性占46.4%,女性占53.6%,平均年龄45.15（4~79）岁。细粒棘球蚴病病例占73.65%（246/334）,多房棘球蚴病病例占24.85%（83/334）,未分型病例占0.15%（5/334）。无症状、轻症、中症、重症、死亡病例分别占40.58%、40.88%、10.80%、5.26%、2.49%。棘球蚴病患者的平均生存质量评分为0.716,其中细粒棘球蚴病患者为0.735,多房棘球蚴病患者为0.661,两者差异有统计学意义（t = 5.464,P < 0.01）。男性患者生存质量评分为0.739,女性患者的为0.696,两者差异有统计学意义（t = 2.986,P < 0.01）。无症状、轻症、中症、重症、死亡的伤残权重分别为0.257、0.280、0.359、0.363和1.000,棘球蚴病平均伤残权重为0.302。人均伤残损失寿命年为1.864,其中细粒棘球蚴病患者为1.64年,多房棘球蚴病患者为2.55年,两者差异有统计学意义（t = 6.669,P < 0.01）。估算我国棘球蚴病的伤残损失寿命年为29.36万人年、减寿年数为2.88万人年,疾病负担为32.24万人年。结论棘球蚴病在我国的流行范围广,疾病负担重,对当地居民的危害不可忽视,亟需加大对该病的防治力度。

关键词: 棘球蚴病, 疾病负担, 伤残权重

Abstract:

Objective To define the disability weight and estimate disease burden of hydatid disease in China. Methods A hospital on hydatid disease was selected in each of the four provinces（Autonomous region） of Gansu, Qinghai, Sichuan, and Xinjiang, from December, 2016 to March, 2017. All inpatients admitted within 1 month were surveyed in each hospital. Two counties with hydatid disease prevalence were selected from each province, and in each county 25 cases of hydatid disease were selected to reach a total of 200 cases. A questionnaire was compiled based on International Classification of Functioning, Disability and Health and the MOS 36 item short form health survey, SF-36, to examine the life quality and analyze disability weights of patients. The disease burden was calculated based on the prevalence, number of patients, disability weights and demography data. Results In Gansu, Qinghai, Sichuan, and Xinjiang Province（Autonomous region） , 76, 95, 79 and 89 questionnaires were received, of which 76, 91, 79, and 88 were valid questionnaires, with a recovery efficiency of 98.53%. Of these questionnaires, 46.4% were from males, and 53.6% from females, with an average age of 45.15 (4-79). Of these patients, 73.65% (246/334) were cases of cystic echinococcosis (CE), 24.85% (83/334) were alveolar echinococcosis(AE), and 0.15%(5/334) were unclassified. The morbidity level of the disease was devided into asymptomatic, mild, medium, severe, and death, which accounted for 40.58%, 40.88%, 10.80%, 5.26% and 2.49%, respectively. The average quality score of patients was 0.716, CE being 0.735 and AE being 0.661 (t = 5.464, P < 0.01 CE vs. AE). The life quality score was 0.739 in male, and 0.696 in female (t = 2.986, P < 0.01). The disability weights of those asymptomatic, mild, medium, severe, and death cases were 0.257, 0.280, 0.359, 0.363 and 1, respectively, with an average of 0.302. The years lived with disability(YLDs) were 1.864 per patient. It was 1.864 for CE patients, for AE patients(t = 6.669, P < 0.01). It was estimated that the disease burden of hydatid disease in China added up to 322.4 thousand disability adjusted life year(DALYs), 293.4 thousand YLDs, 28.8 thousand years of life lost（YLLs). Conclusion Echinococcosis is widely prevalent with a heavy disease burden and an enormous threat to the people’s health in the country.

Key words: Echinococcosis, Disease burdun, Disability weight

中图分类号:

R532.32

张梦媛, 伍卫平, 官亚宜, 王立英, 侯岩岩, 冯宇, 马俊英, 王谦, 王莹, 韩帅, 薛垂召, 吴文婷. 我国棘球蚴病疾病负担分析[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(1): 15-20.

Meng-yuan ZHANG, Wei-ping WU, Ya-yi GUAN, Li-ying WANG, Yan-yan HOU, Yu FENG, Jun-ying MA, Qian WANG, Ying WANG, Shuai HAN, Chui-zhao XUE, Wen-ting WU. Analysis on disease burden of hydatid disease in China[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2018, 36(1): 15-20.

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参考文献 16

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严重程度等级 Severity levels	细粒棘球蚴病Cystic echinococcosis		多房棘球蚴病Alveolar echinococcosis		合计Total^a
严重程度等级 Severity levels	例数 No. cases	占比/% Ratio/%	例数 No. cases	占比% Ratio/%	例数 No. cases	占比% Ratio/%
无症状 Asymptomatic	120	48.78	17	20.48	139	41.62
轻症Mild	100	40.65	38	45.78	140	41.92
中症Medium	21	8.54	15	18.07	37	11.08
重症Severe	5	2.03	13	15.66	18	5.39
合计Total	246	100	83	100	334	100

等级 Severity levels	例数No. cases	生存质量均值Mean	标准差STD	标准误SE	95%可信区间 95% confidence interval	最小值Min	最大值Max
无症状Asymptomatic	139	0.743	0.142 818	0.012 114	(0.718 84,0.766 74)	0.414	0.973
轻症Mild	140	0.720	0.116 613	0.009 856	(0.700 82,0.739 79)	0.467	0.947
中症Medium	38	0.641	0.117 233	0.019 018	(0.602 41,0.679 48)	0.368	0.872
重症Severe	17	0.637	0.094 973	0.023 034	(0.588 42,0.686 09)	0.455	0.787
合计Total	334	0.716	0.131 743	0.007 209	(0.702 23,0.730 59)	0.368	0.973

省（自治区） Province（Autonomous Region）	患病率/% Prevalence/%	流调报告患者数 No. patients reported during the survey	现患者数 No. patients	估计死亡患者数 Estimated death number of patients	伤残损失寿命年 /人年 Years lived with disability/YLDs	减寿年数/人年Years of life lost/YLLs	疾病负担/人年Disability adjusted life year/DALYs
甘肃Gansu	0.19	26 972	26 300	672	49 023.940	4 810.147	53 834.087
青海Qinghai	0.63	26 443	25 785	658	48 062.437	4 715.806	52 778.243
四川Sichuan	1.08	27 890	27 196	694	50 692.485	4 973.862	55 666.347
新疆Xinjiang	0.09	14 079	13 728	351	25 589.799	2 510.828	28 100.627
内蒙古 Inner Mongolia	0.09	3 513	3 426	87	6 385.181	626.503	7 011.684
宁夏Ningxia	0.22	11 331	11 049	282	20 595.071	2 020.754	22 615.825
新疆生产建设兵团Xinjiang Production and Construction Corps	0.06	1 365	1 331	34	2 481.005	243.432	2 724.437
西藏Tibet	1.66	49 935	48 692	1 243	90 761.888	8 905.336	99 667.224
合计Total		161 528	157 507	4 021	293 591.806	28 806.668	322 398.474