目的 了解山东省农村地区人体肠道寄生虫感染现状,为制定防治策略和措施提供科学依据。方法 2015年按照全国人体重点寄生虫病现状调查方案和实施细则开展调查。根据生态区、经济水平、地形等采用分层整群随机抽样的方法,从山东省抽取17个县52个自然村为调查点,每个调查点调查1岁以上常住人口至少250人。采用改良加藤厚涂片法（一粪两检）检测肠道蠕虫虫卵,直接涂片法检测肠道原虫滋养体或包囊,3~6岁儿童加做透明胶纸肛拭法检测蛲虫。记录每个调查点的自然因素、厕所、饮水、饮食等基本情况。采用SPSS 18.0软件进行统计分析,感染率间的比较采用χ²检验或Fisher确切概率法。结果 共调查13 620人,肠道寄生虫总感染率为1.06%（144/13 620）,其中肠道蠕虫感染率为0.87%（118/13 620）,肠道原虫感染率为0.19%（26/13 620）,儿童蛲虫感染率为1.71%（15/877）。共检出5种肠道蠕虫和3种肠道原虫,感染率较高的3种寄生虫分别为鞭虫（0.58%,79/13 620）、蛔虫（0.16%,22/13 620）和蛲虫（0.12%,17/13 620）。118例蠕虫感染者中,混合感染4例,占3.39%,均为蛔虫和鞭虫混合感染。26例原虫感染者均为单一感染。22例蛔虫感染者,轻度感染20例（90.91%）、中度感染1例（4.55%）、重度感染1例（4.55%）;3例钩虫感染者均为轻度感染;79例鞭虫感染者,轻度感染70例（88.61%）、中度感染8例（10.13%）、重度感染1例（1.27%）;1例华支睾吸虫感染者为轻度感染。肠道寄生虫感染率较高的3个县（市、区）依次为威海乳山（8.23%,65/790）、临沂蒙阴（1.51%,16/1 063）和聊城阳谷（1.26%,10/793）。平原生态区感染率为0.61%（41/6 733）,丘陵生态区感染率为1.50%（103/6 887）,两者差异有统计学意义（P < 0.01）;平原生态区蛲虫感染率较高（0.21%）（P < 0.01）,而丘陵生态区鞭虫感染率较高（1.13%）（P < 0.01）。男、女肠道寄生虫感染率分别为0.90%（58/6 476）、1.20%（86/7 144）,两者差异无统计学意义（P > 0.05）。70~79岁年龄组肠道寄生虫感染率最高（2.30%）,不同年龄组人群肠道寄生虫感染率差异有统计学意义（P < 0.01）。学龄前儿童肠道寄生虫感染率最高（1.49%）,但不同职业者差异无统计学意义（P > 0.05）。饮用井水地区肠道寄生虫感染率最高（1.88%）,不同饮用水源地区差异有统计学意义（P < 0.01）。有生食饮食习惯地区肠道寄生虫感染率（1.25%）较无生食饮食习惯地区（0.74%）高（P < 0.01）。未开展过集体驱虫的地区肠道寄生虫感染率（1.19%）较开展过集体驱虫的地区（0.06%）高（P < 0.01）。结论 山东省农村地区肠道寄生虫感染率已降至较低水平,但部分地区鞭虫和儿童蛲虫感染率仍较高,60岁以上人群及学龄前儿童为重点防治人群。

Objective To understand the endemic status of major human intestinal parasites in rural areas of Shandong Province, so as to provide scientific evidence for formulating prevention and control measures. Methods The survey was conducted based on the National Survey Plan and Implementation for Human Key Parasitic Diseases from 2014 to 2015. Total 52 pilot study sites were selected using a stratified cluster random sampling method based on different ecologic and geographic status, economic levels, each site with at least 250 residents enrolled. Fecal samples were collected from all participants and the intestinal helminth eggs in the feces were examined under microscope using Kato-Katz thick smear method. The direct smear method was used to detect intestinal protozoan trophozoites and cysts. The adhesive tape method was used to detect pinworm eggs around anal in children aged 3 to 6. The information for the natural factors, toilet, drinking water and diet and hygiene behaviors were collected for analyzing risks of infections. The difference in infection rates was statistically analyzed by chi-square or Fisher exact test using SPSS 18.0. Results A total of 13 620 people were investigated and the overall intestinal parasite infection rate was 1.06% (144/13 620), among them the intestinal helminth infection rate was 0.87% (118/13 620) and the intestinal protozoa infection rate was 0.19% (26/13 620). The pinworm infection rate in children with age of 3-6 was 1.71% (15/877). Total 5 species of intestinal helminthes and 3 species of intestinal protozoa were identified. The top three intestinal helminths were Trichuris trichiura (0.58%, 79/13 620), Ascaris lumbricoides (0.16%, 22/13 620) and Enterobius vermicularis (0.12%, 17/13 620). Among 118 helminth infecton cases, 4(3.39%) cases were mixed infection, and which were all mixed with Trichuris trichiura and Ascaris lumbricoides, while 26 protozoa infection cases were all single infection. Among 22 Ascaris lumbricoides infection cases, 20(90.91%) cases were mild infection, 1 (4.55%) case was moderate infection and 1 (4.55%) case was severe infection. 3 Ancylostoma sp. infection cases were all mild infection. Among 79 Trichuris trichiura infection cases, 70(88.61%) were mild infection, 8 (10.13%) were moderate infection and 1 (1.27%) case was severe infection. 1 Clonorchis sinensis infection case was mild infection. The top three counties with highest intestinal parasite infection rate were Rushan, Weihai (8.23%, 65/790); Mengyin, Linyi (1.51%, 16/1 063) and Yanggu, Liaocheng (1.26%, 10/793). The intestinal parasite infection rates in population between two ecologic zones were significantly different, with 0.61% in plain ecologic zone and 1.50% in hilly ecologic zone (P < 0.01). The pinworm infection rate was significantly higher in plain zone (0.21%) than in hilly zone (0.04%), while T. trichiura infection rate was significantly higher in hilly zone (1.13%) than in plain zone (0.01%) (P < 0.01). There was no significant difference in intestinal parasite infection between male (0.90%) and female (1.20%) (P > 0.05). The infection rate in old people with age of 70-79 (2.30%) was higher than other age groups with statistical difference (P < 0.01). There was no significant difference in infection rate in population with different occupations or different education even though the prevalence of intestinal parasites was high in preschool children (1.49%) (P > 0.05). Drinking water source was a risky factor, people drinking water from well had higher infection rate of intestinal parasites (1.88%) than people drinking tape water (0.82%) or spring water (0.37%) (P < 0.01). People eating raw vegetable had higher infection rate (1.25%) than people with cooked vegetable (0.74%) (P < 0.01). The population with regular massive anthelmintic drug administration had much lower intestinal parasite infection rate (0.06%) than those without implementation (1.19%) (P < 0.01). Conclusion The intestinal parasite infection rate had decreased significantly in recent years in rural area of Shandong Province and remained at low level, but whipworm infection remained high in some hilly areas and the pinworm infection kept endemic in children in plain area. People over 60 years old and preschool children are the key population who need special care for prevention and control of intestinal parasite infections in Shandong Province.