洞庭湖洲垸型血吸虫病流行区居民肝脾超声显像流行病学调查分析

Epidemiological study of schistosomiasis japonica on liver and spleen with ultrasonographical assessment among inhabitants in Dongting Lake endemic areas

目的了解洲垸型血吸虫病流行区居民感染情况与肝脾状况，探讨超声显像在血吸虫病流行病学中的应用价值。方法采用Kato—Katz法和便携式超声诊断仪对一洲垸型血吸虫病流行区454名5～65岁居民进行病原学与肝脾超声显像检查。结果粪虫卵阳性率为9．38％，男女差异无显著性；人群感染度（EPG）为5．70，男女差异有显著性。农民和学生的粪虫卵阳性率和EPG最高。肝实质Ⅰ级以上比例男性为10．66％，女性为8．10％，男性显著高于女性，肝实质异常比例随年龄而升高。粪虫卵阳性者肝实质异常Ⅱ级以上比例为23．81％，粪虫卵阴性者为8．13％，粪虫卵阳性者显著高于粪虫卵阴性者。结论超声显像检查可评估血吸虫病病情，提高居民的化疗依从性。

Objective To understand the morbidity of schistosomiasis japonica and health status of the liver and spleen of residents in a village and to evaluate the application of ultrasound on schistosomiasis epidemiology. Methods A total of 454 residents aged 5-65 years were examined by methods of Kato-Katz and ultrasound as well as disease history inquiry. Results The positive rate was 9.38% by stool examination, with no significant difference between males and females. The intensity of the infection among population was 5.70 eggs per gram of stool （EPG）, with significant difference between males and females. The stool positive rate and EPG in farmers and students were the highest. Among 10. 66% of the males and 8.10% of the females, as well as in 23.81% of the stool positive and 8.31% of the stool negative, the parenchyma of the liver was abnormal（≥ Grade Ⅰ）,with significant difference between males and females and between the stool positive and the stool negative. The abnormal rate of liver parenchyma went up with the age. Conclusion Ultrasound can evaluate the health status of inhabitants with schistosomiasis japonica and improve the compliance rate of residents to praziquantel chemotherapy.