目的 了解青海省久治县肝棘球蚴病的流行及分布情况。 方法 2018年7-12月,在久治县6个乡（镇）（智青松多镇、门堂乡、白玉乡、索呼日麻乡、哇尔依乡、哇塞乡）,对6岁及以上常驻居民开展腹部超声检查,同时对同意采血样者ELISA检测血清抗棘球蚴IgG抗体,分析久治县肝棘球蚴病流行现状。 结果 腹部超声共检查23 505人,检出肝棘球蚴病患者345例,检出率为1.47%。其中细粒棘球蚴病患者126例,检出率为0.54%,多房棘球蚴病患者219例,检出率为0.93%。多房棘球蚴病检出率高于细粒棘球蚴病（P < 0.05）。男性和女性检出率分别为0.86%（99/11 560）和2.06%（246/11 945）（P < 0.01）。久治县哇尔依乡、白玉乡棘球蚴病检出率较高,分别为3.89%（147/3 782）和3.01%（149/4 949）,明显高于其他乡（镇）（P < 0.01）。职业人群中其他（个体商户及无业人员）和家务者的检出率较高,分别为20.40%（20/98）、17.39%（60/345）,明显高于其余职业人群（P < 0.05）。不同年龄组中20~29和30~39岁组人群的检出率较高,分别为2.01%（112/5 563）和2.16%（189/8 756）,明显高于其他年龄组（P < 0.01）。腹部超声检查的23 505人中,7 845人接受了抗棘球蚴IgG血清抗体ELISA检测,2 305例阳性,阳性率为29.38%,其中107例腹部超声检出患者的血清抗体阳性率为100%。345例肝棘球蚴病患者中,126例为细粒棘球蚴病,其中49例（占38.9%）的包囊直径 > 10 cm;219例为多房棘球蚴病患者,其中浸润型116例,钙化型34例,液化空洞型69例。 结论 青海省久治县肝棘球蚴病检出率较高,是以多房棘球蚴病为主,细粒棘球蚴病为辅的混合流行区。哇尔依乡、白玉乡,中青年人群,女性、家务人员及其他职业人员应列为重点防治地区和人群。

Objective To investigate the endemic status and distribution of hepatic hydatidosis in Jigzhi County, Qinghai Province. Methods Six natural villages (or towns), including Zhiqingsongduo, Mentang, Baiyu, Suohurima, Wa’eryi and Wasai, were selected as survey sites from July to December, 2018. Abdominal ultrasound examination was performed in full-time residents with age over 6 years old. Anti-Echinococcus IgG was detected in the sera from the villagers who were willing to donate blood by ELISA. The endemic status of hepatic hydatidosis in Jiuzhi population was analyzed. Results A total of 23 505 subjects underwent the abdominal ultrasound examination, 345 of them were diagnosed as hepatic hydatidosis with the detection rate of 1.47%, of which 126 as hepatic cystic echinococcosis (0.54%) and 219 as hepatic alveolar echinococcosis (0.93%), with higher prevalence of hepatic alveolar echinococcosis than that of cystic echinococcosis(P < 0.05). The prevalence of hepatic hydatidosis in male (0.86%, 99/11 560) was lower than that in female (2.06%, 246/11 945) with significant difference (P < 0.01). Wa’eryi and Baiyu villages in Jiuzhi County owned the higher prevalence of 3.89% (147/3 782) and 3.01% (149/4 949), respectively, than the rest villages (χ²= 277.926, P < 0.01). Regarding the occupation, self-employed businessmen/the unemployed and those doing housework showed the higher prevalence of 20.40% (20/98) and 17.39% (60/345) compared with other occupational groups (P < 0.05). Those with age within 20-29 and 30-39 years old had the higher prevalence of 2.01% (112/5 563) and 2.16% (189/8 756), respectively, with significant differences compared to other age groups (P < 0.01). Among all subjects, 7 845 were involved in the ELISA assay for testing serological anti-Echinococcus IgG and 2 305 of them were antibody positive with the positive rate of 29.38%. The positive rate of anti-Echinococcus IgG was 100% in 107 cases confirmed by the abdominal ultrasound examination. Among 126 cases with hepatic cystic echinococcosis, 49 of them had cyst over 10 cm in diameter (38.9%). Among 219 cases with hepatic alveolar echinococcosis, 116 presented the infiltrating type, 34 calcified and 69 with liquid/cavitary type. Conclusion The prevalence of hepatic echinococcosis is still high in the population in Jiuzhi, Qinghai, with mixed cystic and alveolar echinococcosis. Alveolar echinococcosis was dominant in this endemic county. People with middle age, female, working at home or other business, living in Wa’eryi and Baiyu villagers had the highest prevalence of hepatic hydatidosis and should be the main target for treatment and prevention.