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目的掌握青海省玛沁县人体棘球蚴病感染状况,为该地区棘球蚴病防治提供依据。方法根据中华人民共和国卫生行业标准《包虫病诊断标准(WS257-2006)》,使用B超扫描和间接血凝试验对玛沁县所辖乡镇1岁以上常住居民进行棘球蚴病患病情况和血清学调查。在优云乡、当洛乡和下大武乡采集犬粪,采用ELISA法进行棘球绦虫粪抗原检测。结果B超结果显示,玛沁县人群棘球蚴病检出率为7.4%(116/1 561),细粒棘球蚴病和多房棘球蚴病检出率分别为5.3%(82/1 561)和2.2%(34/1 561)。人群血清抗体阳性率为23.8%(307/1 288)。82例细粒棘球蚴病患者中,23例棘球蚴直径>10 cm,占28.1%(23/82),最大径者为18 cm。棘球蚴占位数量≥2个的患者24例,占20.7%(24/116)。玛沁县男性和女性患病率分别为5.3%(40/753)和9.4%(76/808),两者差异有统计学意义(P<0.05)。各职业人群中家务、僧侣和牧民的棘球蚴病患病率较高,分别为18.0%(11/61)、12.2%(5/41)和11.1%(84/758),不同年龄组中以60岁以上和30~40岁人群棘球蚴病患病率最高,分别为18.2%(24/132)和10.3%(31/302),10岁以下儿童患病率为2.9%(18/628)。玛沁县棘球蚴病患病率最高的3个乡依次为优云乡、昌麻河乡和当洛乡,患病率分别为11.7%(29/247)、9.5%(6/63)和8.4%(54/645)。共采集犬粪199份,其中棘球绦虫粪抗原阳性54份,阳性率为27.1%(54/199),优云乡的阳性率为40.4%(23/57),显著高于其他两乡(P<0.05)。结论玛沁县以细粒棘球蚴病为主、多房棘球蚴病为辅的混合流行区,以女性、家务和60岁以上人群患病率较高,地区分布上主要集中在优云乡、昌麻河乡和当洛乡。
Objective To master the infection status of human hydatid disease in Maqin County of Qinghai Province and provide basis for prevention and control of hydatid disease in this area. Methods According to the standard of hygienic industry in China, “Echinococcosis diagnostic criteria (WS257-2006)”, B-scan and indirect hemagglutination test were used to investigate the prevalence of hydatid disease among residents over 1 year old in villages and towns under the jurisdiction of Maqin County And serological investigation. The dog feces was collected in Youyun Township, Dangluo Township and Xiaodiwu Township, and the euglena antigen was detected by ELISA. Results The results of B-ultrasound showed that the detection rate of echinococcosis in Maqin County was 7.4% (116/1 561), the detection rates of Echinococcus granulosus and Echinococcosis were 5.3% (82 / 1,561) and 2.2% (34/1 561). Seropositivity of the population was 23.8% (307/1 288). Among 82 cases of patients with Echinococcus granulosus, 23 cases had echinococcus granulosus more than 10 cm in diameter, accounting for 28.1% (23/82) and the largest diameter was 18 cm. Echinococcosis accounted for more than 2 patients in 24 cases, accounting for 20.7% (24/116). The prevalence rates of males and females in Maqin county were 5.3% (40/753) and 9.4% (76/808), respectively, with significant difference (P <0.05). The prevalence of hydatid disease was 18.0% (11/61), 12.2% (5/41) and 11.1% (84/758) respectively for housework, monks and pastoralists in all occupational groups. Among different age groups The prevalence of echinococcosis was highest in people over the age of 60 and 30-40 years old (18.2% (24/132) and 10.3% (31/302), respectively) and 2.9% (18% 628). The three villages with the highest prevalence rate of echinococcosis in Maqin County were 11.7% (29/247) and 9.5% (6/63), respectively, in Youyun Township, Changmahe Township and Dangluo Township, And 8.4% (54/645) respectively. A total of 199 dogs were collected, of which 54 were positive for euglena antigen. The positive rate was 27.1% (54/199), the positive rate was 40.4% (23/57) in Youyun Township, which was significantly higher than that in other two townships P <0.05). Conclusion The population prevalence rate of female, housework and people over the age of 60 in Maqin County is mainly mixed with epidemic echinococcosis, while the area distribution mainly concentrates in Youyun Township, Chang Mahe Township and Dangluo Township.