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目的了解和掌握青海省人体棘球蚴病流行与分布情况。方法于2012年3-9月在青海省43个县(市、区)按牧区、半农牧区、农区和城镇进行分层,根据各层人口数占全县(市、区)人口总数的比例确定各层调查人数及调查村数,对3周岁以上常住居民进行B超检查,开展人群棘球蚴患病情况调查;每层抽取1所小学,或者在学校集中的县城抽取全县所有小学,对6~13岁学生进行腹腔B超检查,同时采集静脉血,用ELISA试剂盒检测血清抗棘球蚴Ig G抗体水平。应用SPSS17.0软件对调查结果进行统计学分析,计算患病检出率和血清抗体阳性率,率间的比较采用χ~2检验。结果青海省43个县(市、区)共抽取683个行政村(社区),B超检查121 683人,检出棘球蚴病患者1 333例,平均患病检出率为1.10%(1 333/121 683)。人群调查结果显示,不同生产类型的牧区、半农牧区、农区、城镇的患病检出率依次为2.51%(1 101/43 822)、0.84%(111/13 228)、0.08%(30/38 882)和0.35%(91/25 751)。性别分布中,男、女患病检出率分别为0.90%(526/58 348)、1.27%(807/63 335),差异有统计学意义(χ~2=38.93,P<0.01);年龄分布中,以30~39岁青壮年人群患病检出率最高,为1.51%(387/25 682),不同年龄组间患病检出率差异有统计学意义(χ~2=80.84,P<0.01);调查对象来自于14个民族,其中1 333例患者主要分布于藏族、汉族、回族、蒙古族和撒拉族,这5个民族的患病检出率分别为2.25%(1 277/56 752)、0.07%(32/44 420)、0.01%(1/8 229)、0.25%(17/6 806)和0.04%(1/2 558),各民族患病检出率间差异有统计学意义(χ~2=1 354.77,P<0.01);职业分布中以宗教人士的患病检出率最高,为5.08%(52/1 024),牧民次之,为2.42%(1 089/44 982)。共抽取小学191所,均来自学校集中的县城,B超检查学生47 747人,检出棘球蚴病者253例,平均患病检出率为0.53%(253/47 747);ELISA检测45 507份血清,阳性者2 693份,血清抗体阳性率为5.92%。结论青海南部各县是棘球蚴病流行严重的地区。
Objective To understand and master the epidemic and distribution of human hydatid disease in Qinghai Province. Methods From March to September 2012, the grazing areas, semi-agricultural and pastoral areas, agricultural areas and towns in 43 counties (cities and districts) of Qinghai Province were stratified. According to the total population of the county (city and district) Of the proportion of the survey to determine the number of layers and the number of villages surveyed, more than 3 years of age residents over the B-ultrasound to carry out the crowd echinococcosis prevalence survey; 1 primary school per level, or in the county center county Primary school, 6 to 13-year-old students were intraperitoneal B-ultrasound, while collecting venous blood, ELISA kit detection of serum anti-Echinococcus Ig G antibody levels. SPSS 17.0 software was used to make statistical analysis on the survey results, and the prevalence of the disease and the positive rate of the serum antibody were calculated. Theχ ~ 2 test was used to compare the rates. Results A total of 683 administrative villages (communities) were sampled from 43 counties (cities and districts) in Qinghai Province and 121 683 were detected by B-mode ultrasonography. A total of 1333 cases of hydatid disease were detected, with an average prevalence of 1.10% (1 333/121 683). The results of the population survey showed that the prevalence rates of pastoral areas, semi-agricultural pastoral areas, rural areas and urban areas with different types of production were 2.51% (1 101/43 822), 0.84% (111/13 228) and 0.08% 30/38 882) and 0.35% (91/25 751). The distribution of male and female prevalence were 0.90% (526/58 348) and 1.27% (807/63 335), respectively, with significant difference (χ ~ 2 = 38.93, P <0.01) Distribution, the highest prevalence of ill adults aged 30-39 years was 1.51% (387/25 682), the prevalence of different age groups were statistically significant (χ ~ 2 = 80.84, P <0.01). The subjects were from 14 ethnic groups, of which 1333 were mainly from Tibetans, Han nationality, Hui nationality, Mongolian nationality and Salar nationality. The prevalence rates of these five ethnic groups were 2.25% (1 277 / 56 752), 0.07% (32/44 420), 0.01% (1/8 229), 0.25% (17/6 806) and 0.04% (1/2 558) Statistical significance (χ ~ 2 = 1 354.77, P <0.01). The highest prevalence rate of religious persons in occupational distribution was 5.08% (52/1 024), followed by pastoralists was 2.42% (1,089 / 44 982). A total of 191 primary schools were collected, all of which were from 47 747 B-check students. 253 cases of echinococcosis were detected, the average prevalence was 0.53% (253/47 747) 507 serum samples, 2 693 were positive, the positive rate of serum antibody was 5.92%. Conclusion The counties in southern Qinghai Province are endemic to hydatid disease.