目的 了解西藏自治区林芝市棘球蚴病流行情况. 方法 于2016年8-10月,采用分层整群抽样方法,按牧区、农区、半农半牧区和城镇等4种不同生产类型地区,在墨脱、朗、米林、察隅、波密和工布江达等6个县抽取行政村.各县按人口数确定抽取行政村的数量.每个行政村抽取200人,对1岁以上常住居民进行腹部B超检查,对疑似病例辅以血清学筛查,结合流行病学史、临床表现及影像学特征对调查对象予以诊断.采用随机数字表法,每个村抽取20名当地村民,每个县再抽取1所县完全小学4～6年级学生,每个年级不少于50名学生,采用一对一问答式进行防治知识和行为调查.每村抽取20户养犬户,每户仅采集1条犬的粪样(1～3g),ELISA检测犬粪棘球绦虫抗原.每个行政村抽取当地繁育、宰杀的羊(猪)10只或牛5头,检查肝、肺等脏器,记录动物年龄和发现的包囊数量.在检出多房棘球蚴病患者的行政村的居民居住地周围1 km范围内捕捉各种成年鼠(不少于300只),剖检鼠肝、肺棘球蚴感染情况.采用SPSS 19.0统计学软件对数据进行统计分析.结果 共抽取6个县28个行政村开展调查,B超检查5 016人,检出棘球蚴病病例47例,其中细粒棘球蚴病病例42例(占89.36％),多房棘球蚴病病例5例(占10.64％).6个县均检出细粒棘球蚴病病例,工布江达、察隅、波密等3个县发现多房棘球蚴病病例.男、女性的棘球蚴病检出率分别为0.78％ (17/2 167)和1.05％ (30/2 849).年龄最小的为2岁,最大的为93岁,各年龄组均有病例检出,人群棘球蚴病检出率随着年龄的增长而升高(x2=16.151,P＜ 0.05).不同文化程度人群的棘球蚴病检出率差异无统计学意义(x2=3.073,P＞0.05).林芝地区只有两种生产类型,半农半牧区的检出率为1.01％ (44/4 376),高于农区的检出率(0.47％,3/640) (x2=1.733,P＞ 0.05).男性和女性半农半牧区的检出率均为最高,分别为4.02％ (8/199)和3.43％ (7/204).犬粪棘球绦虫抗原阳性率为3.59％ (18/501),家犬和野犬粪棘球绦虫抗原阳性率分别为3.21％ (11/343)和4.43％(7/158),两者差异无统计学意义(x2=0.467,P＞0.05).察隅县啮齿类动物棘球蚴感染检出率为1.45％ (5/345).仅1头猪检出棘球蚴感染.人群总的棘球蚴病防治知识认知合格率为27.40％ (385/1 405),不同县人群总的棘球蚴病防治知识认知合格率差异有统计学意义(x2=23.020,P＜0.05). 结论 林芝市6个县均有细粒棘球蚴病病例分布,3个县发现多房棘球蚴病病例.“,”Objective To understand the prevalence of echinococcosis in Nyingchi City in Tibet Autonomous Region.Methods A stratified cluster sampling method was used to select 6 counties among pastoral area,agricultural area,semi-agricultural and semi-pastoral area,and town,from August to October,2016.In each county,the number of villages for survey was determined by the population size of each county.Two hundred residents were selected,residents aged ＞ 1 year received B-ultrasound examination in combination with epidemiological history,clinical manifestations and imaging features for diagnosis.Those suspected were also subjected to a serological test.In each village,20 local residents were selected using a random number table method,and in each county,a primary school was selected,from which 50 students of grades 4-6 were selected.Their knowledge on hydatid disease control and their behaviors were surveyed by face-to-face Q & A.In each village,20 dog-raising households were selected using a random number table method,and in each household fecal samples (1-3 g) were collected from only one dog.Echinococcus antigen was detected by ELISA in dog feces.In each village,10 sheep/pigs or 5 cattle were selected to examine internal organs including liver and lung.The ages of animals and number of cysts found were recorded.At least 300 adult rodents were caught within 1 km away from the spots of the residents who were detected to have alveolar echinocoeeosis,and hydatid cysts in liver and lung were examined by autopsy.Prevalence of hydatid disease in cattle and sheep was investigated by biopsy combined with PCR.Statistical analysis was carried out using SPSS 19.0 statistical software.Results A total of 28 villages were investigated in 6 counties,and 5 016 residents received B-ultrasound examination,among whom 47 were detected with hydatid disease,comprising 42 cases of cystic hydatid disease (89.36％,42/47) distributed in the 6 counties and 5 cases of alveolar hydatid disease (10.64％,5/47) distributed in 3 counties (Gongbu Jiangda,Chayu,Bomi).The prevalence in males and females was 0.78％ (17/2 167) and 1.05 ％ counties (30/2 849),respectively.From the youngest of 2 years to the oldest of 93 years,each age group was found with hydatid disease,and the prevalence increased with age (x2 =16.151,P＜ 0.05).There was no significant difference in the prevalence by education levels (x2 =3.073,P ＞ 0.05).Of the only two production types in Nyingchi City,the prevalence was higher in semi-agricultural and semi-pastoral area (1.01％,44/4 376) than in agricultural area (0.47％,3/640)(x2 =1.733,P ＞ 0.05).Higher prevalence in semiagricultural and semi-pastoral area was also found in males (4.02％,8/199) and females (3.43％,7/204).The antigen positive rate in dog feces was 3.59％ (18/501),3.21％ (11/343) in domestic dogs and 4.43％ (7/158) in stray dogs (x2 =0.467,P ＞ 0.05).The infection rate in rodents in Chayu County was 1.45％ (5/345).Only 1 pig was detected.The qualified rate of knowledge on hydatid disease control was 27.40％ (385/1 405).Conclusion Cystic hydatid disease is prevalent in all the 6 counties,while alveolar hydatid disease is detected in 3 counties of Nyingchi.