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目的 调查西藏自治区人群泡型包虫病流行情况,以及中间宿主感染情况,为西藏泡型包虫病防治提供科学依据. 方法 按照整群随机抽样的方法选取样本,用B超检查全腹部,现场初筛后保存3张B超影像图片及B超动态影像资料,最后请专家会诊并最终作出定性及分型诊断.各地(市)随机抽取1个存在泡型包虫病病人的县开展啮齿类动物调查,现场解剖后对存在病变的肝脏、肺脏进行PCR检测. 结果 B超筛查共80 384人,其中2012年在4个县筛查3 335人,2016年在剩余的70个县筛查364个村77 049人,泡型包虫病总患病率为0.20％.西藏7地市均有泡型包虫病流行,其中那曲地区患病率较高,为0.30％;山南市患病率较低,为0.04％.全西藏74个县有47个县有泡型包虫病流行,以尼木县患病率较高,为1.02％;桑珠孜区患病率较低,为0.03％.牧区人群患病较高,为0.36％(57/15 757),半农半牧区为0.30％(63/20 814),农区为0.14％(28/12 184),城镇为0.02％(5/4 102).不同生产类型间泡型包虫病患病率差异有统计学意义(x2 =8.471,P＜0.05).男、女性泡型包虫病患病率分别为0.15％(53/34 297)和0.22％(100/46 087),差异有统计学意义(x2=4.037,P＜0.05).不同文化程度人群中,文盲患病率较高,为0.25％(101/39 616).不同文化程度人群泡型包虫病患病率差异有统计学意义(x2=22.976,P＜0.01).牧民、半农牧、农民出率较高,分别为0.34％(63/18 558)、0.29％(29/10 078)、0.14％(45/31 369);学龄前儿童患病率较低,为0.02％.不同职业人群患病率差异有统计学意义(x2 =44.491,P＜0.01).年龄分布方面,40～、50～、60～、≥70岁组人群患病率分别为0.25％(35/14 150)、0.21％(26/12 099)、0.39％(26/6 628)和0.36％(12/3 365),差异有统计学意义(x2=38.149,P＜0.01).随年龄增高,患病率增高.文盲人群患病率较高,为0.22％(102/46112).PCR检测拉萨市尼木县中间宿主泡球蚴(基因)阳性率较高,为3.96％(4/101),丁青县和察隅县分别为2.17％(2/92)和1.45％(5/345).全区推算患病率为0.20％. 结论 西藏泡型包虫病流行严重,应加大筛查力度,早发现早治疗病人.啮齿类动物泡球蚴感染严重,应加强灭鼠,控制泡型包虫病的传播.“,”Objective To investigate distribution of alveolar echinococcosis in human and infection of intermediate host in Tibet Autonomous Region,and to provide scientific basis for prevention and control of alveolar echinococcosis in local.Methods Samples were selected using cluster random sampling method.Three b-ultrasonic images and dynamic images were saved after primary screen conducted by B-ultrasonography to make an abdominal check,which can obtain a qualitative and classification diagnosis through expert consultation finally.We selected one county where patients with alveolar echinococcosis exist from every prefecture randomly to conduct the investigation on rodents and made a PCR test to the samples of liver and lungs with lesions after the dissection of animals.Results There were 80 384 people tested by Bultrasonography,3 335 of whom in 4 counties were screened in 2012,while other 77 049 people in 364 villages in 70 counties were done in 2016.Total prevalence rate of alveolar echinococcosis was 0.20％.Cases were reported in every prefecture.Prevalence rate in Nagqu Prefecture was high,which was 0.30 ％,while the rate in Lhoka Prefecture was 0.04％,which was much lower.Alveolar echinococcosis was distributed in 47 of 74 counties in Tibet.Prevalence rate in Nyemo County was 1.02 ％ while that in Shigatse County was 0.03 ％.Prevalence in pastoral area,farming-pastoral region,rural area and urban were 0.36％ (57/15 757),0.30％ (63/20 814),0.14％ (28/12 184),0.02％(5/4 102) respectively,which showed a significant statistical difference in different types of production(x2 =22.976,P＜0.01).Prevalence in different professions showed a significant statistical difference(x2 =44.491,P＜0.01).Prevalence in age group of 40-,50 -,60-and ≥70 were 0.25％(35/14 150),0.21％(26/12 099),0.39％(26/6 628) and 0.36％(12/3 365) respectively,which existed a significant statistical difference(x2-38.149,P＜0.01).Prevalence increased with age.Prevalence rate of illiterate population was high,which was 0.22 ％ (102/46112).Positive rate of echinococcus multilocularis DNA in intermediate host detected by PCR was 3.96％(4/101),2.17％(2/92) and 1.45％(5/345) in Nyemo County of Lhasa City,Dengqen County and Zayu County.Estimated prevalence of the whole region was 0.20％.Conclusion Epidemic of alveolar echinococcosis was severe,which prompted us to reinforce the screening and make the detection and treatment as early as possible.Infection of echinococcus multilocularis in rodents was serious,which should strengthen deratization to control the spread of alveolar echinococcosis.