目的 了解西藏自治区日喀则市棘球蚴病流行现状. 方法 采用分层整群抽样方法,于2016年8-10月抽取日喀则市17个县(区) (亚东县于2012年已调查)的调查村,对1岁以上常住居民进行B超检查,疑似病例辅以血清学检测,计算人群棘球蚴病检出率,推算患病率和患病人数.每个调查村随机抽取家畜(猪、羊)10头或牛5头,采用内脏剖检法调查家畜棘球蚴病患病情况.发现细粒棘球蚴病病例的县,在患者居住地周围和犬经常活动的区域捕捉各种成年鼠数不少于300只,检查啮齿类动物棘球蚴感染情况.每个调查村随机抽取20个养犬户,采集犬粪,ELISA检测棘球绦虫抗原.随机抽取每个调查村20名村民,每个县抽1所完全小学4～6年级学生,采用问卷形式调查人群棘球蚴病防治知识认知情况. 结果 B超共检查日喀则市18个县(区)96个调查村21 497人(包含2012年调查的亚东县的数据),检出棘球蚴病患者289例,检出率为1.34％.推算人群患病率为1.10％,推算患病人数为7 792例.检出病例中以细粒棘球蚴病为主,占90.31％ (261/289).全市18个县(区)均有细粒棘球蚴病流行,13个县(区)同时发现多房棘球蚴病病例.不同县(区)中,仲巴县检出率最高,为4.03％ (33/819),仁布县最低,为0.24％ (2/833);不同地区棘球蚴病检出率差异有统计学意义(x2=39.963,P＜0.05).女性棘球蚴病检出率为1.50％(191/12 737),高于男性的1.12％ (98/8760) (x2=5.676,P＜ 0.05).不同年龄组中,≥70年龄组棘球蚴病检出率最高,为2.75％ (22/799),1～9岁年龄组检出率最低,为0.34％ (12/3 479);人群棘球蚴病检出率随着年龄的增长而升高(x2=61.390,P＜0.05).不同文化程度中,文盲人群检出率最高,为1.56％ (190/12 214),小学、大专及以上人群检出率较低,分别为1.04％ (74/7 086)和1.08％ (4/372);不同年龄组棘球蚴病检出率差异有统计学意义(x2=61.502,P＜ 0.05),且有随文化程度增高而呈降低的趋势(x2趋势=5.704,P＜ 0.05).不同职业中,牧民的棘球蚴病检出率最高,为2.68％ (76/2 831);不同职业棘球蚴病检出率差异有统计学意义(x2=75.110,P＜ 0.05).不同生产类型中,牧区的棘球蚴病检出率最高,为1.83％ (85/4 654),农区最低,为0.91％ (75/8 285);不同生产类型人群的棘球蚴病检出率差异有统计学意义(x2=24.450,P＜0.05).终宿主犬粪棘球绦虫抗原阳性率为4.73％ (92/1 946),家犬(5.42％,66/1 218)和野犬(3.57％,26/728)的棘球绦虫粪抗原阳性率差异无统计学意义(x2=3.155,P＞0.05).中间宿主啮齿类动物棘球蚴感染检出率为1.02％ (3/293),家畜(牛、羊)棘球蚴感染检出率为11.61％ (67/577).人群棘球蚴病防治知识认知合格率为33.08％(1 500/4 534),且小学生的棘球蚴病防治知识认知合格率(39.57％,1 064/2 689)高于居民的(23.63％,436/1 845) (x2=125.541,P＜ 0.05). 结论 西藏自治区日喀则市人群和动物棘球蚴病/棘球绦虫病流行情况重,女性、高年龄组、低文化水平、牧民人群应为重点防治对象.“,”Objective To understand the prevalence of echinococcosis in Shigatse City in Tibet Autonomous Region.Methods A stratified cluster sampling method was used to select villages in 17 counties (district) in Shigatse City from August to October,2016.B ultrasound examination was performed in residents aged ＞ 1 year,accompanied by a serological test for those suspected,to calculate the prevalence of hydatid disease.The prevalence and the number of cases in the population of the city were estimated.Ten pigs/sheeps or 5 cattle were randomly selected in each village,to examine the status of echinococcosis disease in livestock by visceral dissection.In counties found with cases of echinococcosis,no less than 300 adult rodents were captured in places of patient residence and with frequent activity of humans and dogs,to calculate the prevalence of echinococcosis in rodents.In each village,20 households raising dogs were randomly selected to collect dog feces.Echinococcus antigen in fecal samples was determined by ELISA.Knowledge on echinococcosis prevention and control was surveyed in 20 residents randomly selected in each village,and in grade 4-6 students in a primary school of each county questionnairing.Resuits A total of 21 497 residents in 96 villages of 18 counties (district) received B ultrasound,of whom 289 were detected with echinococcosis (1.34％).The prevalence in population was estimated to be 1.10％,and the number of cases was estimated to be 7 792.The cases were dominated by cystic echinococcosis (90.31％,261/289).The 18 counties (district) were all found with cystic echinococcosis cases,and 13 were also found with alveolar echinococcosis.The estimated prevalence was highest in Zhongba County (4.03％,33/819),and lowest in Renbu County (0.24％,2/833),with significant difference among the counties (x2 =39.963,P ＜ 0.05).The prevalence in females was 1.50％ (191/12 737),significantly higher than that in males (1.12％,98/8 760) (x2 =5.676,P＜ 0.05).Among different age groups,the prevalence was highest in the age group of ≥ 70 years (2.75％,22/799),and lowest in the age group of 1-9 years (0.34％,12/3 479),showing a trend of increase with age (x2 =61.390,P ＜ 0.05).As to the education levels,the prevalence was highest in the illiterates (1.56％,190/12 214),and lower in those with a primary school level (1.04％,74/7 086) and college and above (1.08％,4/372) (x2 =61.502,P ＜ 0.05,among different education levels).The prevalence showed a trend of decrease with increased education level (x2 =5.704,P ＜ 0.05).The prevalence was highest in herdsmen (2.68％,76/2831) (x2 =75.110,P＜ 0.05,among different occupations).The prevalence was highest in pastoral area (1.83％,85/4 654) and lowest in agricultural area (0.91％,75/8 285) (x2 =24.450,P ＜ 0.05,among different production types).The positive rate of Echinococcus antigen in dog fecal samples of the terminal host dogs was 4.73％ (92/1946),showing no significant difference (x2 =3.155,P ＞0.05) between domestic dogs (5.42％,66/1 218) and stray dogs (3.57％,26/728).The infection rate in rodents was 1.02％ (3/293),and that in livestock (cattle,and sheep) was 11.61％ (67/577).The populational qualified rate on knowledge of echinococcosis prevention was 33.08％ (1 500/4 534),being higher in pupils (39.57％,1 064/2 689)than in residents (23.63％,436/1 845) (x2 =125.541,P ＜ 0.05).Conclusion Echinococcosis both in human populations and animals are widely prevalent in Shigatse.More attention should be paid to females,herdsmen and populations with older age and less education.