棘球蚴病病例病灶型别分布特征横断面分析

薛垂召, 刘白雪, 王旭, 伍卫平, 郑灿军, 蒉嫣, 韩帅

doi:10.11853/j.issn.1003.8280.2024.05.017

中国媒介生物学及控制杂志 >

2024 , Vol. 35 >Issue 5: 604 - 615

DOI: https://doi.org/10.11853/j.issn.1003.8280.2024.05.017

调查研究

棘球蚴病病例病灶型别分布特征横断面分析

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1. 中国疾病预防控制中心寄生虫病预防控制所(国家热带病研究中心), 国家卫生健康委员会寄生虫病原与媒介生物学重点实验室, 世界卫生组织热带病合作中心, 科技部国家级热带病国际研究中心, 传染病溯源预警与智能决策全国重点实验室, 上海 200025;
2. 中国疾病预防控制中心, 传染病溯源预警与智能决策全国重点实验室, 北京 102206

薛垂召,男,硕士,助理研究员,主要从事流行病学研究,E-mail:xuecz@nipd.chinacdc.cn

收稿日期: 2024-04-08

网络出版日期: 2024-10-18

基金资助

中国疾控中心寄生虫病所科技创新支撑计划(LY2024012);上海市卫生健康委员会科研项目(20214Y0207)

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Cross-sectional analysis of distribution characteristics of lesion subtypes in cases of echinococcosis

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1. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China;
2. Chinese Center for Disease Control and Prevention, National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing 102206, China

Received date: 2024-04-08

Online published: 2024-10-18

Supported by

Technology Innovation Support Program from National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (No. LY2024012); Shanghai Municipal Health Commission (No. 20214Y0207)

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摘要

目的了解我国棘球蚴病病例病灶型别、部位、数量等分布,为棘球蚴病诊断、防治和病例管理提供理论基础。方法选择2012-2016年中国包虫病流行病学调查中病灶影像学分型资料较完整的病例,描述性统计病灶分型分布,使用回归分析法分析各型别病灶数与相应型别病例数的关系。结果纳入研究的4 014例病例中,囊型、泡型棘球蚴病病灶各型别病例占比的性别差异均无统计学意义（均P>0.05）。囊型棘球蚴病各型别不同省份病例占比差异均有统计学意义（χ²=58.803～534.097,均P<0.05）,除内囊破裂型（Ⅲ型）外的其他型别不同职业病例占比差异均有统计学意义[囊型CL、多子囊型（Ⅱ型）、实变型（Ⅳ型）、钙化型（Ⅴ型）：Fisher确切概率法检验均P<0.05；Ⅰ型：χ²=104.534,P<0.001]。泡型棘球蚴病浸润型、液化空洞型、钙化型病例各型别不同省份病例占比差异均有统计学意义（Fisher确切概率法检验均P<0.05）,各型别不同职业病例数占比差异均有统计学意义（Fisher确切概率法检验P<0.001；P=0.009；P<0.001）。同时罹患囊型和泡型棘球蚴病病例中未发现有液化空洞型合并囊型病灶、囊型钙化型（Ⅴ型）合并泡型病灶。四川省（Z=-2.630,P=0.009）和新疆维吾尔自治区（Z=-2.254,P=0.024）囊型病灶各阶段病例占比的依次降低趋势有统计学意义。各型别囊型病例中≥90.92%的病例病灶占位部位为肝脏。各型别病灶数与相应型别的病例数呈显著的负指数幂关系（均P<0.05）。结论我国棘球蚴病病例在病灶分型上有地域、职业特性,病灶主要位于肝脏。病灶分型横断面分析可以作为传统流行病学分析的重要补充,为棘球蚴病的防治提供重要理论依据。

关键词： 棘球蚴病; 病灶分型; 病灶数量; 病灶部位; 回归分析

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薛垂召, 刘白雪, 王旭, 伍卫平, 郑灿军, 蒉嫣, 韩帅 . 棘球蚴病病例病灶型别分布特征横断面分析[J]. 中国媒介生物学及控制杂志, 2024 , 35(5) : 604 -615 . DOI: 10.11853/j.issn.1003.8280.2024.05.017

Abstract

Objective To investigate the distribution of the subtypes, location, and number of lesion in echinococcosis cases in China, so as to provide a theoretical basis for the diagnosis, prevention, and management of echinococcosis. Methods Cases with complete information on lesion types based on images obtained in the 2012-2016 epidemiological survey of echinococcosis in China were selected for descriptive analysis of lesion subtype distribution. Regression analysis was performed to determine the relationship between the number of lesions in each subtype and the number of cases in the corresponding subtype. Results Among the 4 014 cases included in the study, there were no significant differences between male and female patients in the proportions of cystic and alveolar echinococcosis cases in each subtype of lesion (all P>0.005). For cystic echinococcosis cases, there were significant differences in the proportion of cases among different provinces of each subtype （χ²=58.803～534.097, all P<0.05）, and there were significant differences in the proportion of cases among different occupations except for type III （subtype CL,Ⅱ,Ⅳ,Ⅴ：P<0.05 by Fisher's exact probability test; subtypeⅠ：χ²=104.534, P<0.001）. For alveolar echinococcosis cases, there were significant differences in the proportion of cases among different provinces of each subtype, i.e., infiltrative, colliquative and cavitary, calcification （all P<0.05 by Fisher's exact probability test）, and there were significant differences in the proportion of cases among different occupation of each subtype （Fisher's exact probability test： P<0.001; P=0.009; P<0.001）. Colliquative and cavitary subtype with cystic lesion as well as cystic and calcified type with alveolar lesion were not found in cases with both cystic and alveolar lesions. The proportions of cystic lesions in different stages decreased significantly in turn in Sichuan Province (Z=-2.630, P=0.009) and Xinjiang Uygur Autonomous Region (Z=-2.254, P=0.024). Not less than 90.92% of the lesions of all subtypes of cystic echinococcosis cases were located in the liver. Regression analysis showed a significant negative exponential relationship between the number of lesions of each subtype and the number of cases with the corresponding subtype lesion (all P<0.05). Conclusions There are regional and occupational characteristics in the subtype of lesions in echincoccosis cases in China, and the lesions are mainly located in the liver. The cross-sectional analysis of lesion classification can be used as an important supplement to the traditional epidemiological analysis and provide an important theoretical basis for the control, prevention, and treatment of echinococcosis.

Key words： Echinococcosis; Lesion type; Lesion number; Lesion location; Regression analysis

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