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目的了解2012年青海省玉树藏族自治州棘球蚴病的流行情况。方法 2012年6-8月在青海省玉树藏族自治州称多县、囊谦县、曲麻莱县、玉树县、杂多县和治多县等6县各抽取2~3个镇,对1岁以上常住居民进行B超检查,调查人群患病情况。ELISA检测人血清棘球蚴抗体。内脏剖检法调查鼠类和牲畜的棘球蚴感染情况;现场随机采集无主犬犬粪,ELISA检测犬粪棘球蚴抗原。结果B超检查共7 025人,查出棘球蚴病患者319例,患病率为4.54%。ELISA检测共2 790人,血清棘球蚴抗体阳性率为16.38%(457/2 790)。其中,人群患病率以称多县最高,为7.41%(181/2 444),血清抗体阳性率以玉树县最高,为23.18%(127/548)。男性患病率和血清抗体阳性率分别为3.91%(118/3 018)和13.93%(172/1 235),女性分别为5.02%(201/4 007)和18.33%(285/1 555)。年龄分布以60~岁和40~岁人群的患病率较高,分别为8.39%(38/453)和6.61%(67/1 014),70岁以上人群的血清抗体阳性率最高,为33.93%(19/56)。不同职业中,牧民、半农半牧和宗教人士的患病率较高,分别为5.28%(252/4 777)、6.52%(24/368)和3.37%(11/326),血清抗体阳性率以儿童、宗教人士和牧民较高,分别为24%(6/25)、18.79%(31/165)和18.34%(328/1 788)。不同文化程度中,文盲人群的患病率和血清抗体阳性率均最高,分别为5.04%(241/4 779)和18.34%(359/1 958)。不同居住方式中,冬季定居夏季游牧人群的患病率和血清抗体阳性率均最高,分别为8.25%(227/2 753)和19.48%(158/811)。不同地区、性别、年龄、职业、文化程度、居住方式间的患病率和血清抗体阳性率差异均有统计学意义(P<0.05或P<0.01)。共检查鼠类872只,棘球蚴检出率为0.46%(4/872)。共检查牛、羊809只,棘球蚴检出率为10.14%(82/809)。采集无主犬犬粪共838份,棘球蚴粪抗原阳性率为10.74%(90/838)。结论玉树州人群棘球蚴病患病率和血清棘球蚴抗体阳性率较高,牛、羊棘球蚴检出率和无主犬棘球蚴粪抗原阳性率较高。
Objective To understand the prevalence of hydatid disease in 2012 in Yushu Tibetan Autonomous Prefecture of Qinghai Province. Methods From June to August 2012, 2 or 3 townships were sampled in 6 counties in Yushu Tibetan Autonomous Prefecture of Qinghai Province, including Duoxian County, Baqian County, Qumalai County, Yushu County, Zaduo County and Zhiduo County, The above resident residents to carry out B-ultrasound to investigate the prevalence of the crowd. ELISA detection of human serum hydatid antibody. The visceral dissection method was used to investigate the echinococcosis infection in mice and livestock. Dogs and canoes were collected randomly at the scene and the echinococcosis antigen was detected by ELISA. Results A total of 7 025 persons were examined by B-mode ultrasound. 319 cases of hydatid disease were found, the prevalence was 4.54%. A total of 2 790 people were detected by ELISA. The positive rate of serum antibody of hydatid cyst was 16.38% (457/2 790). Among them, the prevalence of the population in Jinduo County was the highest, 7.41% (181/2 444). The highest positive rate of serum antibody in Yushu County was 23.18% (127/548). The prevalence rates of males and seropositives were 3.91% (118/3 018) and 13.93% (172/1 235) respectively, with females 5.02% (201/4 007) and 18.33% (285/1 555), respectively. The prevalence of age distribution was higher in people aged 60 to 40 years old and 8.3% (38/453) and 6.61% (67/1 014), respectively. The highest positive rate of serum antibody was 33.93 % (19/56). Among different occupations, the prevalence rates of herdsmen, semi-peasant, semi-herders and religious people were higher (5.28% (252/4 777), 6.52% (24/368) and 3.37% (11/326) respectively) Rates were higher for children, religious figures and pastoralists, at 24% (6/25), 18.79% (31/165) and 18.34% (328/1 788) respectively. Among different education levels, illiteracy prevalence rate and serum antibody positive rate were the highest (5.04% (241/4 779) and 18.34% (359/1 958 respectively. Among different living styles, the prevalence of summer nomadic herds in summer and the positive rate of serum antibody were the highest, which were 8.25% (227/2 753) and 19.48% (158/811) respectively. The prevalence rates of different regions, sexes, ages, occupations, educational level, living styles and the positive rate of serum antibodies were all statistically significant (P <0.05 or P <0.01). A total of 872 rats were examined, the detection rate of hydatid cyst was 0.46% (4/872). A total of 809 cattle and sheep were examined, and the detection rate of hydatid cyst was 10.14% (82/809). A total of 838 canine samples of dogs were collected, and the positive rate of echinococcus manure antigen was 10.74% (90/838). Conclusions The prevalence of hydatidosis and the positive rate of serum hydatid cyst are high in the population of Yushu Prefecture. The detection rate of Echinococcus granulosus and the positive rate of excreted antigen of Echinococcus granulosus are high.