目的试图从9县市人群钩端螺旋体抗体水平探析钩体主要流行群和隐性与显性感染比例。方法选择以前钩体病发病率较高的9县市中无钩体疫苗接种史的10~65岁常住村民1 240人作为对象,于流行高峰前采取外周静脉血,按国家标准方法做显微镜凝集试验(MAT)测15群15型钩体抗体;用SPSS统计软件进行统计学分析。结果9县13群钩体抗体的阳性率和隐性感染率差异有统计学意义的分别有9群(黄疸出血、拜伦、澳洲、流感伤寒、波摩那、秋季、犬群、七日热和曼耗)和3群(黄疸出血、澳洲和波摩那)。交叉阳性率差异亦有统计学意义,最高为湘潭(80.39%)、最低为南县(36.17%)。黄疸出血群隐感率最高为湘潭(38.24%)、最低系岳阳(1.60%)。以黄疸出血群抗体滴度1∶≥80为标准推测隐性感染与显性感染比例为53 700∶1;以≥320为标准,则为11 500∶1。结论不同县市钩体主要流行群不同,但以黄疸出血群为主;推荐黄疸出血群钩体隐性感染抗体滴度以1∶≥200为宜,隐性与显性感染比例约为3万分之一;本地区钩体将以散发为主,流行的概率较小。 OBJECTIVE: To explore the prevalence of leptospira and the proportion of latent and dominant infection in Leptospira antibody from 9 counties and cities. Methods A total of 1 240 live-from-home villagers from 10 to 65 years old in 9 counties with higher incidence of leptospirosis were enrolled in this study. Peripheral venous blood was collected before the peak of the epidemic. Microscope agglutination was performed according to the national standard Test (MAT) 15 groups of 15 leptospira antibodies; using SPSS statistical software for statistical analysis. Results There were 9 groups (jaundice bleeding, Byron, Australia, influenza, typhoid, Pomona, autumn, canine, seven heat and Manx consumption) and 3 groups (jaundice bleeding, Australia and Pomona). Cross positive rates were also statistically significant, the highest for Xiangtan (80.39%), the lowest county (36.17%). The highest incidence rate of icterus bleeding was Xiangtan (38.24%) and the lowest was Yueyang (1.60%). The ratio of latent infection to dominant infection was estimated to be 53 700: 1 based on the titers of 1: 80 in the jaundice hemorrhage population, and 11 500: 1 for ≥320. Conclusions The prevalence of leptospirosis in different counties and cities is different, but the majority of them are jaundice. The titers of latent infection in ligation of jaundice hemorrhage are recommended to be 1: 200, and the ratio of hidden and dominant infection is about 30,000 One; the local area will be distributed to the main hook, the probability of prevalence is smaller.