目的 探索青海省棘球蚴病的主要影响因素，为开展干预提供科学依据。方法 在青海省棘球蚴病的重点流行区（果洛州、海北州、海南州、海西州、黄南州、玉树州）和非重点流行区（海东市、西宁市）对成年人棘球蚴病患者的感染因素开展病例对照研究。以居住地、年龄、性别、民族为匹配因素，按照1:2成组匹配对照，以是否患病为因变量进行单因素分析，构建logistic回归模型，分析居民患棘球蚴病的影响因素。使用SPSS 22.0统计学软件进行统计学分析。结果 本研究符合纳入标准的病例组共1 447人，平均年龄为（38.7 ± 13.3)岁；男性58.3%（844/1 447)，女性41.7%（603/1 447)；藏族65.2%（944/1 447)，汉族22.9%（332/1 447)，回族6.6%（95/1 447)。对照组共2 894人，平均年龄为（38.5 ± 13.0）岁；男性58.3%（1 688/2 894)，女性41.7%（1 206/2 894)；藏族60.5%（1 751/2 894)，汉族26.4%（763/2 894)，回族6.0%（175/2 894)。单因素分析结果显示，养犬、养犬方式、犬的用途、犬经常接触饮水、犬粪未经处理、经常与犬接触、养家畜等25个因素在病例组和对照组间的差异有统计学意义（χ² = 143.53、46.88、40.26、80.63、38.77、107.16、117.27，均P < 0.01）。多因素logistic回归分析结果显示，养犬方式（OR = 1.37，95% CI：1.03~1.82）、犬的用途（OR = 1.59，95% CI：1.01~2.51）、犬接触饮用水（OR = 1.63，95% CI：1.19~2.24）、犬粪处理（OR = 2.51，95% CI：1.95~3.26）、近一年在家屠宰牲畜（OR = 1.44，95% CI：1.09~1.91）、家周围有屠宰场或肉店（OR = 1.67，95% CI：1.21~2.26）、犬喂食生的家畜脏器（OR = 1.53，95% CI：1.18~2.03）、家周围有野生动物（OR = 1.53，95% CI：1.19~1.95）、饮用未煮沸的水（OR = 1.42，95% CI：1.05~1.91）、饮用水储存方式（OR = 1.88，95% CI：1.37~2.59）、防治知识（OR = 1.75，95% CI：1.36~2.28）等11个因素是成年人棘球蚴病患病的主要危险因素。结论 犬相关行为、卫生习惯、生产生活方式和防治知识知晓情况与青海省成年人患棘球蚴病高度相关，是青海流行区棘球蚴病干预的核心行为学因素。

Objective To study the main influencing factors to echinococcosis in Qinghai Province, to provide scientific basis for interventions. Methods A case-control study was conducted on the infection factors of adult echinococcosis cases in the significant endemic areas (Guoluo, Haibei, Hainan, Haixi, Huangnan and Yushu) and in the nonsignificant endemic areas (Haidong and Xining) of Qinghai Province. The study was carried out by setting the matching factors of age, sex and ethnicity, with the maching control ratio of patients against heathy people 1:2, defining whether or not the disease case as the dependent variable for univariate analysis using a logistic regression model constructed to analyze the factors influencing residents contracting echinococcosis. Statistical analysis was conducted using SPSS 22.0 statistical software. Results A total of 1 447 cases met the inclusion criteria was enrolled as the case group in this study, with a mean age of (38.7 ± 13.3) years, 58.3% male (844/1 447), 41.7% female (603/1 447), 65.2% Tibetan (944/1 447), 22.9% Han Chinese (332/1 447), 6.6% Hui (95/1 447); the control group consisted of 2 894 individuals with a mean age of (38.5 ± 13.0) years, 58.3% male (1 688/2 894), 41.7% female (1 206/2 894), 60.5% Tibetan (1 751/2 894), 26.4% Han (763/2 894), and 6.0% Hui (175/2 894). The results of univariate analysis showed that 25 factors, such as canine ownership, canine breeding method, canine use, frequent contact with drinking water, no disposal of canine feces, frequent contact with canine, and domestic animal ownership, were statistically significant between the case and control groups (χ² = 143.53, 46.88, 40.26, 80.63, 38.77, 107.16, 117.27; P < 0.01). Multivariate logistic regression analysis showed that the type of canine ownership (OR = 1.37, 95%CI: 1.03-1.82), use of canines (OR = 1.59, 95% CI: 1.01-2.51), canine contacted with drinking water (OR = 1.63, 95% CI: 1.19-2.24), disposal of canine feces (OR = 2.51, 95% CI: 1.95-3.26), slaughter of livestock at home in the last year (OR = 1.44, 95% CI: 1.09-1.91), slaughterhouse or butcher shop around home (OR = 1.67, 95% CI: 1.21-2.26), canine fed with raw livestock organs (OR = 1.53, 95% CI: 1.18-2.03), drinking unboiled water (OR = 1.42, 95% CI: 1.05-1.91), living with wild animals around home (OR = 1.53, 95% CI: 1.19-1.95), drinking water storage method (OR = 1.88, 95% CI: 1.37-2.59), as well as prevention knowledge (OR = 1.75, 95% CI: 1.36-2.28) were the main risk factors for echinococcosis prevalence in adults. Conclusion This study indicates that the factors of dog-related behavior, hygienic habits, lifestyle and the wareness on knowledge of disease prevention and control are highly associated with echinococcosis in adults in Qinghai Province and are the key behavioural factors in echinococcosis intervention in Qinghai endemic areas.