青海省果洛州人与动物棘球蚴病调查

A survey and analysis on echinococcosis in Guoluo Prefecture of Qinghai Province

目的 通过对青海省果洛州人群与动物棘球蚴病的调查与分析，了解当地棘球蚴病在人群和动物中的流行与分布状况。方法 应用B超对人群进行患病率调查；囊液抗原间接血凝试验（IHA）法筛查人群棘球蚴抗体的阳性率；并分别用重组Em18（rEm18）、重组抗原B（rAgB）和Eg囊液抗原（EgcF），对随机选取的B超检查和IHA检测阳性者进行ELISA试验，与B超诊断结果进行符合率比较，评价泡型棘球蚴病（AE）、囊型棘球蚴病（CE）的分布情况；应用ELISA检测家犬和藏狐粪抗原阳性率；现场检查牛、羊胸腹腔，确定牛、羊感染率。结果 人群调查：①B超检查2826人，总患病率为9．45％。血清IHA法检查1113人，阳性率25．79％。女性人群的患病率和血清阳性率均显著高于男性；②血清囊液抗原IHA检测阳性者（108）与ELISA法检测EgcF，阳性符合率为66．94％：3种重组抗原检测，ELISA法与IHA法阳性符合率为75．00％。③B 超法诊断棘球蚴病（88人）与ELISA法检测，符合率EgcF为94．32％，rAgB为68．18％，rEm18为51-4％。EgcF阳性率符合率为69．44％：3种抗原检测与IHA检测总体阳性符合率为75．00％。61例CE患者中，血清ELISA法检测，EgcF阳性率为96．72％，rAgB为68．85％，rEm18为33.33％；26例AE患者中，EgcF和rEm18阳性率均为92-31％，rAgB为65．39％。动物调查：①高原鼠兔棘球蚴感染率21．74％。经cytb基因分析，证实有多房棘球绦虫（E．muhilocularis）和石渠棘球绦虫（Eshiquicus）感染。绵羊棘球蚴感染率82．61％，牦牛棘球蚴感染率78．52％。②野犬、藏狐、猞猁均有不同程度的棘球绦虫感染。结论 青海省果洛州人群与动物中存在棘球蚴病的高度流行。E．shiquicus种的幼虫和成虫分别在高原鼠兔和藏狐体内寄生已得到证实，提示果洛州为3种棘球蚴的混合流行区。

Objective To know the epidemiologieal situation and distribution characteristics of eehinoeoeeosis in Guoluo Prefecture of Qinghai Province, the morbidity in local residents, and infection status in the domestic and wild animals were investigated. Methods B-ultrasound examination was applied for diagnoses of human hydatidosis morbidity. EgeF-IHA was used to test human hydatid infection rate. Afterwards, the sera from positive human determined by B-ultrasound examination and the sera positive for EgeF-IHA were checked with rEm18-ELISA, rAgB-ELISA and EgeF-ELISA respectively. In addition, eopro-antigen test using ELISA was used to examine the positive rate of the feces from Tibetan foxes and dogs;Yaks and sheep were also checked for infection at slaughter places. Results Among 2826 persons examined by B-ultrasound, 267 were found to have hydatidosis with a total prevalence of 9.45%. The IHA examination revealed a general positive rate of 25.79%. The infection rate in female was remarkably higher than that in male. 108 sera positive for EgeF-IHA and 88 patients diagnosed by B-ultrasound were checked by ELISA coated with antigen rEml8, rAgB and EgeF respectively. The results showed that the positive rate for antigen rEm18, rAgB and EgcF were 22.22%, 8.33% and 69.44% in 108 sera respectively. Of 61 CE, 20 cases were found positive for antigen rEm18, 42 cases for antigen rAgB and 59 cases for antigen EgcF. The infection rate of Oehotona eurzoniae in intermediate hosts was 21.74% , and the cysts from Oehotona eurzoniae were confirmed to be E.shiquicus infection by eytb gene analysis. The positive rates of yaks and sheep were 78.52% and 82.61%. All definitive hosts, such as dogs, tibetan foxes and lynxes, had been found infected with Echinococcus spp. to some extent. Condusions In Guoluo Prefecture of Qinghai Province, the epidemics of echinococcosis/Echinococcus in the population, the domestic and wild animals is serious. This area was also confirmed to be an endemic region with mixed prevalence of Echinococcus spp. including E.granulosus, E.multilocularis and E.shiquicus.