本文選題：包蟲病 + 住院病例　； 參考：《寧夏醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：本研究通過流行病學(xué)調(diào)查方法對寧夏回族自治區(qū)2002年—2013年包蟲病住院病例進(jìn)行回顧調(diào)查，揭示我區(qū)包蟲病流行的三間分布特征，及患病住院情況。并與上個十年（1992年—2001年）已有資料的包蟲病病例分布進(jìn)行對比，比較兩個時間段的變化。選擇西吉縣進(jìn)行泡型包蟲病中間宿主的調(diào)查，對西吉縣4-18歲人群泡型包蟲病感染狀況和中間宿主進(jìn)行調(diào)查，分析泡型包蟲病的流行傳播模式。為衛(wèi)生行政部門制定包蟲病防治策略提供科學(xué)依據(jù)。 方法：對全區(qū)縣級及以上醫(yī)院2002年—2013年包蟲病住院病例進(jìn)行收集，對1992年—2001年歷史流調(diào)資料進(jìn)行拷貝和整理。對西吉且15個鄉(xiāng)25個村4-18歲人群采集血液，對抗泡型包蟲病抗體進(jìn)行ELISA檢測。對西吉縣泡型包蟲病中間宿主嚙齒類動物進(jìn)行捕捉和種類鑒定和分布密度調(diào)查。 結(jié)果：共收集2002年—2013年包蟲病住院病例調(diào)查病例2334份，平均住院病例率為3.09/10萬人口。整理1992年—2001年包蟲病住院病例2271份。從年份來看，病例數(shù)呈逐年上升然后下降趨勢。兩個時間段包蟲病病例均主要分布在同心縣、原州區(qū)和海原縣。包蟲病病例主要集中在青壯年，不同性別間，不同民族間，不同年齡組間均有統(tǒng)計學(xué)差異（P 0.05）。西吉縣泡型包蟲病4-18歲人群感染情況調(diào)查共采集血樣1772份，血清陽性率為6.72%，泡型病血清陽性率分布最高的鄉(xiāng)為興平鄉(xiāng)（12.4%），其次為沙溝鄉(xiāng)（10.9%）。分布最多的區(qū)域為西南區(qū)（8.9%），其次為西北區(qū)（8.8%）。不同性別間血清陽性率有統(tǒng)計學(xué)差異（P 0.05），不同民族、不同年齡組間沒有統(tǒng)計學(xué)差異（P0.05）。嚙齒類動物的調(diào)查共布設(shè)鼠夾2244個，捕獲到嚙齒類動物133只，鼠夾捕獲率為5.9%。捕獲到嚙齒類動物最多的是長尾倉鼠（65.4%），優(yōu)勢種長尾倉鼠分布最多的區(qū)為西北區(qū)（30%），其次為西南區(qū)（27%）。中間宿主密度的調(diào)查觀察到較多的倉鼠和鼢鼠，，與2003年相比黃鼠種群的數(shù)量減少而鼢鼠種群可能增加。 結(jié)論：我區(qū)包蟲病感染普遍，全區(qū)各縣市均有包蟲病病病例分布，其流行特點(diǎn)為南部山區(qū)高發(fā)。泡型包蟲病住院病例數(shù)在2009年以后逐步下降，它是經(jīng)濟(jì)發(fā)展、移民政策、包蟲病防治項目實施等多方面作用的結(jié)果。泡型包蟲病在西吉縣兒童青少年中感染率較高，長尾倉鼠為西吉縣的優(yōu)勢鼠種，長尾倉鼠密度大的區(qū)域人血清陽性率也高，說明在相應(yīng)區(qū)域內(nèi)存在活躍的泡型包蟲病傳播循環(huán)。當(dāng)?shù)嘏菪桶x病傳播模式可能為嚙齒動物—犬間循環(huán)，有待進(jìn)一步證實。
[Abstract]:Objective: to investigate retrospectively the hospitalized cases of hydatid disease in Ningxia Hui Autonomous region from 2002 to 2013 by means of epidemiological investigation. Compared with the distribution of hydatidosis cases in the last decade (1992-2001), the changes of the two periods were compared. The infection status and intermediate host of alveolar echinococcosis were investigated in Xiji county, and the epidemic transmission pattern of alveolar hydatid disease was analyzed. To provide scientific basis for health administrative department to formulate strategy of preventing and controlling hydatid disease. Methods: the hospitalized cases of hydatid disease were collected from 2002 to 2013 in hospitals at county level and above in the whole district. The data of historical flow from 1992 to 2001 were copied and sorted out. Blood was collected from 25 villages of Xiji and 25 villages, and the antibody against alveolar hydatid disease was detected by ELISA. The rodents of alveolar echinococcosis in Xiji County were captured, species identified and their distribution density investigated. Results: a total of 2334 cases of hydatid disease were investigated from 2002 to 2013, with an average hospitalization rate of 30.9% -100 000. 2271 cases of hydatid disease were collected from 1992 to 2001. From the point of view of year, the number of cases increased year by year and then decreased. The cases of hydatid disease were mainly distributed in Tongxin County, Yuanzhou District and Haiyuan County. The cases of hydatid disease were mainly concentrated in young adults, different sexes, different nationalities, different age groups, there were statistical differences (P 0.05). A total of 1772 blood samples were collected from the population aged 4-18 years old in Xiji County. The positive rate of serum was 6.722.The highest distribution of serum positive rate of alveolar echinococcosis was Xingping County 12.4D, followed by Shagou Township 10.9%. The most distributed area is the southwest area, and the second is the northwest area. There was a significant difference in serum positive rate among different genders (P 0.05), but there was no significant difference in serum positive rate among different nationalities and different age groups (P 0.05). A total of 2244 rodent clamps were set up and 133 rodents were captured. The capture rate of rodents was 5.9%. The most common rodents were the long-tailed hamsters (65.4m), the most dominant species was the northwestern part of the Hamster, and the second was the southwest area. More hamsters and zokors were observed in the investigation of intermediate host density. Compared with 2003, the number of yellow rat population decreased, but the zokor population may increase. Conclusion: hydatidosis infection is common in our region, and there are cases of hydatidosis in all counties and cities of our region, and its epidemic characteristic is high incidence in southern mountainous area. The number of hospitalized cases of alveolar echinococcosis decreased gradually after 2009, which is the result of economic development, immigration policy and the implementation of echinococcosis control projects. The infection rate of alveolar echinococcosis was higher in children and adolescents in Xiji County. The long tailed hamster was the dominant species in Xiji county, and the positive rate of human serum in the area with high density of long tailed hamster was also high, which indicated that there was an active circulation of transmission of vesicular hydatid disease in the corresponding area. The transmission pattern of local alveolar hydatid disease may be rodent-dog circulation, which needs further confirmation.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R532.32

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