目的 探讨西藏自治区巴青县人群多房棘球蚴病（AE）的主要影响因素，为牧区棘球蚴病防控提供科学依据。方法 基于2023年1月—2024年10月在西藏自治区巴青县开展的人群棘球蚴病筛查，以经腹部B超检查并依据WS 257—2006《包虫病诊断标准》确诊的AE患者为病例组，同期筛查排除棘球蚴病的居民为对照组，按性别相同、年龄相近（± 5岁）、居住于同一或地理相邻行政村的匹配原则，采用1∶2匹配病例，每个匹配集包含1例病例和2名对照。于2024年9月—2025年5月由统一培训的调查员进行面对面问卷调查。问卷内容包括一般人口学特征、犬只饲养与管理情况、环境暴露因素、个人行为习惯等。采用R软件进行统计学分析，组间比较采用χ²检验；AE患病影响因素采用条件logistic回归分析。结果 共调查258人，其中病例组86人，对照组172人，均为藏族。病例组平均年龄为（44.6 ± 14.2）岁，对照组为（44.1 ± 14.1）岁，两组差异无统计学意义（t = 0.26，P > 0.05）。病例组与对照组在性别、职业、教育水平、身体质量指数值、婚姻状况、家庭常住人口等方面差异均无统计学意义（χ² = 0.00、1.53、0.83、4.09、0.71、0.53，均P > 0.05）。单因素条件logistic回归分析结果显示，养犬[OR = 2.82，95%置信区间（CI）：1.45~5.48]、犬只从不驱虫（OR = 3.22，95% CI：1.09~9.48）、犬粪不规范处理（OR = 4.86，95% CI：2.09~11.30）、经常与犬接触（OR = 2.98，95% CI：1.42~6.24）、家周围有狐狸（OR = 2.42，95% CI：1.37~4.27）、主要饮用江河水（OR = 2.55，95% CI：1.26~5.16）、饮用生水（OR = 2.02，95% CI：1.17~3.48）以及经常食用未清洗新鲜虫草（OR = 3.87，95% CI：1.55~9.67）与AE患病风险相关（均P < 0.05）。多因素条件logistic回归分析结果显示，养犬时间 > 5年（OR = 4.68，95% CI：1.09~20.17）、犬粪不做处理（OR = 9.35，95% CI：2.39~36.64）、与犬经常接触（OR = 6.92，95% CI：1.21~39.51）及饮用水来源为江河湖泊沟塘水（OR = 4.97，95% CI：1.07~23.20）等4个因素是AE患病的主要危险因素。结论 巴青县人群AE的发生与犬源管理及饮水安全密切相关，应加强犬只管理和犬粪规范处理、改善饮水卫生条件并强化牧民健康教育。

Objective To identify the main influencing factors of human alveolar echinococcosis (AE) in Baqing County, Xizang Autonomous Region, so as to provide insights into echinococcosis control in pastoral areas. Methods Based on the human echinococcosis screening programme in Baqing County, Xizang Autonomous Region from January 2023 to October 2024, AE patients that were definitively diagnosed with abdominal B‑mode ultrasonography and based on WS 257-2006 Diagnostic Criteria for Echinococcosis were selected as the case group, and residents that were free of echinococcosis as revealed by abdominal B-mode ultrasonography during the same time served as controls. Matching was performed based on the same gender, similar age (± 5 years), and residence in the same or geographically adjacent administrative villages, with one case matched to two controls. From September 2024 to May 2025, a face to face questionnaire survey was conducted by uniformly trained investigators, and the questionnaire covered general demographics, dog breeding and management, environmental exposure factors, and personal behavioral habits. All statistical analyses were performed using the software R, with chi square test used for between group comparisons, and a conditional logistic regression model for identifying factors affecting the risk of AE. Results A total of 258 residents from Baqing County were enrolled, including 86 cases in the case groups and 172 matched controls, and all subjects were Tibetan residents. The mean age was (44.6 ± 14.2) years in the case group and (44.1 ± 14.1) years in the control group, with no statistically significant difference （t = 0.26, P > 0.05）, and no significant differences were observed in gender, occupation, educational level, body mass index, marital status, or household size (χ² = 0.00, 1.53, 0.83, 4.09, 0.71 and 0.53, all P > 0.05). Univariate conditional logistic regression analysis identified significant associations of dog breeding (OR = 2.82, 95% CI: 1.45-5.48), never deworming for dogs (OR = 3.22, 95% CI: 1.09-9.48), improper disposal of dog feces (OR = 4.86, 95% CI: 2.09-11.30), frequent contact with dogs (OR = 2.98, 95% CI: 1.42-6.24), presence of foxes around the residence (OR = 2.42, 95% CI: 1.37-4.27), use of river/stream water as the main drinking water source (OR = 2.55, 95% CI: 1.26-5.16), drinking unboiled water (OR = 2.02, 95% CI: 1.17-3.48), and frequent consumption of unwashed fresh Cordyceps (OR = 3.87, 95% CI: 1.55-9.67) with the risk of AE (all P < 0.05), and multivariate analysis identified dog breeding duration for > 5 years (OR = 4.68, 95% CI: 1.09-20.17), non disposal of dog feces (OR = 9.35, 95% CI: 2.39-36.64), frequent contact with dogs (OR = 6.92, 95% CI: 1.21-39.51), and drinking water sourced from rivers, lakes, ditches, or ponds (OR = 4.97, 95% CI: 1.07-23.20) as main risk factors for AE. Conclusion The development of human AE is closely associated with dog management and drinking water safety in Baqing County. It is recommended to reinforce dog management and standardized disposal of dog feces, improve drinking water sanitation, and enhance health education among herders.