阿里地区棘球蚴病流行现状

摘要/Abstract

摘要：

目的了解西藏自治区阿里地区棘球蚴病流行现状,为制定科学的防治对策提供依据。方法于2016年8-10月,采用分层整群抽样的方法,抽取阿里地区噶尔、改则、普兰、札达、革吉、日土和措勤等7个县进行棘球蚴病流行情况调查,对居民进行腹部B超检查,结合流行病学史、临床表现及影像学特征对调查对象予以诊断,对疑似病例辅以血清学筛查。采用随机数字表法,每个村抽取20名当地村民;每个县抽取一所县完全小学4~6年级学生,每个年级不少于50名学生,采用一对一问答式进行防治知识和行为调查。采用SPSS 19.0统计学软件对数据进行统计分析。结果对阿里地区7个县22个行政村4 740名居民进行棘球蚴病检测,检出棘球蚴病病例111例,检出率为2.34%（111/4 740）,其中细粒棘球蚴病病例94例,检出率为1.98%(94/4 740);多房棘球蚴病病例13例,检出率为0.27%（13/4 740）;未分型病例4例,检出率为0.08%(4/4 740)。棘球蚴病检出率居前3位的县依次为措勤县3.76%（31/824）、改则县3.18%(32/1 007)、噶尔县2.13%(18/847),且7个县人群的棘球蚴病检出率差异有统计学意义（χ² = 45.816,P < 0.01）。男女性别比1 : 1.92,女性的检出率为2.93%（73/2 489）,明显高于男性的1.69%（38/2 251）(χ² = 8.008,P < 0.01)。60~岁年龄组检出率最高,各年龄段棘球蚴病检出率差异有统计学意义（χ² = 43.161,P < 0.01）。不同职业人群棘球蚴病检出率最高为牧民3.34%（78/2 338）。牧区棘球蚴病检出率最高,为2.53%（87/3 437）。结论西藏自治区阿里地区是棘球蚴病高发地区,女性,牧民,年龄60岁以上组应为重点防治人群。

关键词: 棘球蚴病, 流行现状, 阿里地区

Abstract:

Objective To investigate the prevalence of hydatid disease in Ali of Tibet Autonomous Region, in order to lay foundation for setting up control strategy for the disease. Methods Administrative villages were selected from 7 counties (Geer, Gaize, Pulan, Zhada, Geji, Ritou and Cuoqin) using stratified cluster sampling method from August to October, 2016. Residents received B ultrasound examination, and diagnosed based on a combination of epidemiological history, clinical manifestations and imaging features. Serological test was performed in those suspected cases. In each village, 20 local residents were selected using a random number table method. In each county, a primary school was selected, from which 50 students of grades 4-6 were selected using a random number table method. Their knowledge on echinococcosis control and behaviors were surveyed by face-to-face Q & A. Statistical analysis was carried out using SPSS 19.0 statistical software. Echinococcus antigen in the dog feces was detected by ELISA. Data were analyzed by SPSS 19.0. Results A total of 4 740 residents in 22 villages of the 7 counties were examined, and 111 were found with hydatid disease (2.34%), comprising 94 with cystic echinococcosis (1.98%) and 13 with alveolar echinococcosis (0.27%), and 4 unclassified cases (0.08%). There was a significant difference in the prevalence among the 7 counties (χ² = 45.816, P < 0.01), with the top 3 being Cuoqin County (3.76%, 31/824), Gyeonggi County (3.18%, 32/1 007) and Gyar County (2.13%, 18/847). The residents examined had a male-to-female ratio of 1 : 1.92. The prevalence in females was 2.93% (73/2 489), significantly higher than that in males (1.69%, 38/2 251) (χ² = 8.008, P < 0.01). The prevalence was highest in the age group of > 60 years (4.05%, 9/222), and was significantly different among different age groups (χ² = 43.161, P < 0.01). The prevalence was highest in herdsmen (3.34%, 78/2 338) among different occupations; and was highest in pastoral area (2.53%, 87/3 437). Conclusion Hydatid disease occurs heavily in Ali. More efforts should be made to prevent the disease. More attention should be paid to females, herdsman and those with an old age.

Key words: Hydatid disease, Prevalence, Ali Prefecture

中图分类号:

R532.32

肖丹, 伍卫平, 雪莲, 贡桑曲珍, 次仁拉姆, 边巴卓玛, 王栋民. 阿里地区棘球蚴病流行现状[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(1): 54-57.

Dan XIAO, Wei-ping WU, Lian XUE, Qu-zhen GONGSANG, La-mu CIREN, Zhuo-ma BIANBA, Dong-min WANG. Prevalence of hydatid disease in Ali Prefecture[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2018, 36(1): 54-57.

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参考文献 18

[1]	刘平, 李金花, 李印, 等. 包虫病病原在我国的流行现状及成因分析[J]. 中国动物检疫, 2016, 33(1): 48-51.
[2]	王乐, 冯晓辉, 段新宇, 等. 999例包虫病住院患者经济负担分析[J]. 中华流行病学杂, 2010, 31(7): 835-836.
[3]	蒋次鹏. 我国包虫病流行近况[J]. 地方病通报, 2002, 17(3): 77-79.
[4]	王国强, 于竞进, 王宇, 等. 全国包虫病流行情况调查报告[M]. 上海: 上海科学技术出版社, 2016: 10-11.
[5]	国务院人口普查办公室, 国家统计局人口和就业统计司. 中国2010年人口普查资料[M]. 北京: 中国统计出版社, 2012: 2462.
[6]	中华人民共和国卫生部. 《包虫病诊断标准》(WS257-2006)[S]. 北京: 人民卫生出版社, 2006.
[7]	王尚位, 陈绍荣, 李远林, 等. 云南祥云县包虫病流行病学调查[J]. 热带病与寄生虫学, 2005, 3(2): 103-104.
[8]	张静妮, 韩秀敏, 雷雯, 等. 青海省学生包虫病防治知识现状调查[J]. 中国血吸虫病防治杂志, 2016, 28(5): 578-580.
[9]	马霄, 王虎, 韩秀敏, 等. 青海省玛沁县棘球蚴病流行情况调查[J]. 中国寄生虫学与寄生虫病杂志, 2015, 33(4): 269-272.
[10]	金小林, 李健, 沈明学, 等. 江苏省包虫病流行病学调查[J]. 中国病原生物学杂志, 2009, 4(9): 682-684.
[11]	张贤昌. 包虫病防治[J]. 华南预防医学, 2007, 33(4): 74-76.
[12]	王东, 冯宇, 李凡, 等. 甘肃省藏区人群棘球蚴病流行现状调查及分析[J]. 中国寄生虫学与寄生虫病杂志, 2017, 35(2): 140-144.
[13]	赵建华, 吴向林, 马荣, 等. 宁夏2012年棘球蚴病流行现况调查分析[J]. 宁夏医学杂志, 2014, 36(4): 314-317.
[14]	刘俊刚, 殷志兰. 内蒙古锡林浩特地区包虫病流行状况调查分析[J]. 包头医学, 2009, 33(1): 38-39.
[15]	王立英, 伍卫平, 朱雪花. 2004-2008年全国包虫病疫情分析[J]. 中国人兽共患病学报, 2010, 26(7): 699-702.
[16]	宋壮志, 郝慧霞, 姜晓峰, 等. 内蒙古自治区包虫病流行现况调查[J]. 首都公共卫生, 2017, 11(2): 53-55.
[17]	徐克均, 王再跃, 黎开洪. 2011年甘孜藏族自治州包虫病疫情分析[J]. 寄生虫病与感染性疾病, 2013, 11(1): 34-36.
[18]	贾万忠. 我国包虫病的防治现状[J]. 兽医导刊, 2011(6): 30-33.

县County	检查人数 No. exam′d	细粒棘球蚴病 Cystic echinococcosis		多房棘球蚴病 Alveolar echinococcosis		未分型病例 Unclassified		合计Total
县County	检查人数 No. exam′d	检出患病人数 No. patients	检出率/% Prevalence/%	检出患病人数 No. patients	检出率/% Prevalence/%	检出患病人数 No. patients	检出率/% Prevalence/%	检出患病人数 No. patients	检出率/% Prevalence/%
措勤县Cuoqin	824	23	2.79	8	0.97	0	0	31	3.76
改则县Gaize	1 007	24	2.38	4	0.40	4	0.40	32	3.18
噶尔县Geer	847	18	2.13	0	0	0	0	18	2.13
革吉县Geji	803	14	1.74	0	0	0	0	14	1.74
普兰县Pulan	449	7	1.56	0	0	0	0	7	1.56
札达县Zhada	407	5	1.23	0	0	0	0	5	1.23
日土县Ritou	403	3	0.74	1	0.25	0	0	4	0.99
合计Total	4 740	94	1.98	3	0.27	4	0.08	111	2.34

特征 Features		检查人数 No. exam′d	检出患病人数 No. patients	检出率/%Prevalence/%
性别 Gender	男Male	2 251	38	1.69
性别 Gender	女Female	2 489	73	2.93
年龄组 Age group	1~19	1 440	16	1.11
年龄组 Age group	20~39	1 743	32	1.84
	40~59	1 168	36	3.08
	≥ 60	389	27	6.94
职业 Occupation	学龄前儿童 Preschool children	434	3	0.69
职业 Occupation	学生Students	787	11	1.40
	农民Farmers	233	3	1.29
	半农半牧民 Semi-herdsman-and-farmers	502	8	1.60
	牧民Herdsmen	2 338	78	3.34
	其他Others	446	8	1.79

县County	牧区 Pastoral area			半农半牧区 Semi-agricultural and semi-pastoral area			农区 Agricultural area
县County	检查人数 No. exam′d	检出患病人数 No. patients	检出率/% Prevalence/%	检查人数 No. exam′d	检出患病人数 No. patients	检出率/%Prevalence/%	检查人数 No. exam′d	检出患病人数 No. patients	检出率/% Prevalence/%
措勤县Cuoqin	824	31	3.76	0	0	0	0	0	0
改则县Gaize	1 007	32	3.18	0	0	0	0	0	0
噶尔县Geer	200	3	1.50	647	15	2.32	0	0	0
革吉县Geji	803	14	1.74	0	0	0	0	0	0
普兰县Pulan	0	0	0	222	3	1.35	227	4	1.76
札达县Zhada	200	3	1.50	207	2	0.97	0	0	0
日土县Ritou	403	4	0.99	0	0	0	0	0	0
合计Total	3 437	87	2.53	1 076	20	1.86	227	4	1.76