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目的了解甘肃省10个藏区县人群棘球蚴病流行情况。方法 2011年9月-2012年6月在甘肃省10个藏族自治州(县)进行分层随机抽样,每县共抽取16个行政村。采用B超扫描的方法,开展人群棘球蚴病流行情况调查。应用SPSS 20.0软件对调查结果进行描述和统计学分析,患病检出率比较采用χ~2检验。结果共抽样检查37 815人,所有调查点均发现棘球蚴病例;以县为单位的人群患病检出率为0.05%~1.59%,平均0.59%(224/37 815);患病检出率大于1%的县分别为夏河县1.59%(64/4 019)、玛曲县1.37%(44/3 206)、肃南县1.20%(60/5 000)。总人群男性患病检出率为0.53%(108/20 276)、女性患病检出率为0.66%(116/17 539),两者间差异无统计学意义(χ~2=2.647,P>0.05),但藏族女性(0.71%,93/13 146)和男性(0.46%,73/15 709)患病检出率间差异有统计学意义(χ~2=7.372,P<0.05)。不同年龄组间患病检出率差异有统计学意义(χ~2=109.346,P<0.05),其中20~岁组最低,为0.28%(19/6 687),80~岁组最高,为2.41%(4/166),患病检出率曲线随年龄增长呈现增高趋势。不同民族间患病检出率差异无统计学意义(χ~2=1.710,P>0.05),回族患病检出率最高,为0.92%(5/546)。不同职业人群间患病检出率差异有统计学意义(χ~2=33.345,P<0.05),其中商人患病检出率最高,为3.32%(2/62)。共发现细粒棘球蚴病223例,多房棘球蚴病1例,无混合感染病例。其中单脏器寄生占98.21%(220/224);累及肝脏占94.76%(217/229);单包囊占81.70%(183/224);60岁及以上年龄组中多包囊比例(28.57%,22/77)高于60岁以下组(12.93%,19/147),两者间差异有统计学意义(χ~2=8.273,P<0.05)。结论甘肃省10个藏区县存在不同程度的细粒棘球蚴病流行,其中夏河县、玛曲县、肃南县流行严重。藏族女性、60岁以上者、商人是该病的重点干预人群。
Objective To understand the prevalence of hydatid disease in 10 Tibetan counties in Gansu Province. Methods From September 2011 to June 2012, 10 Tibetan autonomous prefectures (counties) in Gansu Province were stratified and randomly sampled. A total of 16 administrative villages were selected in each county. Using B-scan method to carry out population epidemiology survey of hydatid disease. SPSS 20.0 software application description and statistical analysis of the survey results, the prevalence of the detection rate using χ ~ 2 test. Results A total of 37 815 people were sampled. All cases were found hydatid disease cases. The prevalence of the disease was 0.05% ~ 1.59% in the county population, with an average of 0.59% (224/37 815) The counties with a rate of over 1% were Xiahe County 1.59% (64/4 019), Maqu County 1.37% (44/3 206) and Sunan County 1.20% (60/5000) respectively. The prevalence rate of male in the general population was 0.53% (108/20 276), and the prevalence rate of female was 0.66% (116/17 539). There was no significant difference between the two groups (χ ~ 2 = 2.647, P > 0.05). However, there was significant difference in the prevalence of Tibetan women (0.71%, 93/1346) and male (0.46%, 73/159 709) (χ ~ 2 = 7.372, P <0.05). There was a significant difference in the prevalence of disease among different age groups (χ ~ 2 = 109.346, P <0.05), of which the lowest in 20 ~ age group was 0.28% (19/6 687), the highest in 80 ~ age group was 2.41% (4/166), the prevalence of the detection rate curve showed an increasing trend with age. There was no significant difference in prevalence among different ethnic groups (χ ~ 2 = 1.710, P> 0.05). The prevalence rate of Hui was highest (0.92%, 5/546). There were significant differences in prevalence among different occupational groups (χ ~ 2 = 33.345, P <0.05). Among them, the prevalence rate of traders was the highest (3.32%, 2/62). A total of 223 cases of Echinococcus granulosus were found, one case of multilocular echinococcosis, no mixed infection. Among them, single organ parasitism accounted for 98.21% (220/224); liver involved 94.76% (217/229); single cysts accounted for 81.70% (183/224); multiple cysts in age group 60 and older (28.57 %, 22/77) were higher than those under 60 years old (12.93%, 19/147), the difference was statistically significant (χ ~ 2 = 8.273, P <0.05). Conclusion There are different degrees of Echinococcus granulosus in 10 Tibetan counties in Gansu Province. Among them, Xiahe County, Maqu County and Sunan County are endemic. Tibetan women, people over the age of 60, the disease is a key intervention in the crowd.