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江西省血吸虫性肝纤维化人群流行病学特征分析

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目的 分析江西省现存血吸虫性肝纤维化患者的流行病学特征,为当地精准管理和治疗提供科学依据.方法 收集2021年江西省血吸虫性肝纤维化患者的性别、年龄、文化程度、职业、所在地流行类型和疫情类别等基本信息,通过B超检查获取患者肝纤维化分级情况,对其三间分布特征、肝纤维化程度等进行描述性分析.结果 2021年江西省共有血吸虫性肝纤维化患者17 575例,平均年龄为(64.9±12.6)岁,男女比例为1.45∶1,文化程度以初中及以下为主(96.83%,17 017/17 575),职业多为农民(90.09%,15 833/17 575),主要分布在处于传播控制的九江市(7 546例)、上饶市(7 072例)和南昌市(2 192例).肝纤维化程度为Ⅰ级、Ⅱ级和Ⅲ级的患者分别占总数的36.03%(6 333/17 575)、52.38%(9 206/17 575)和11.58%(2 036/17 575).湖沼型和山丘型流行区患者肝纤维化分级均以Ⅱ级为主,分别占46.40%(4 004/8 630)和58.16%(5 202/8 945);传播控制及消除地区以Ⅱ级为主,分别占49.48%(4 109/8 305)和71.19%(4 149/5 828),传播阻断地区以Ⅰ级为主,占69.67%(2 398/3 442);不同流行类型和疫情类别地区患者肝纤维化分级构成比差异均有统计学意义(χ2=248.21,H=509.81,P均<0.05).40岁及以下患者肝纤维化分级均以Ⅰ级为主,40岁以上患者肝纤维化分级则以Ⅱ级为主,所有年龄段患者肝纤维化分级均以Ⅲ级占比最低.不同年龄组患者肝纤维化分级构成比差异有统计学意义(H=204.89,P<0.05).结论 江西省血吸虫性肝纤维化患者主要分布于传播控制地区,肝纤维化程度以Ⅰ级和Ⅱ级居多.对血吸虫病患者开展肝纤维化早期筛查、精准干预,可有效控制慢性血吸虫病发展为晚期血吸虫病例.
Analysis on the epidemiological characteristics in population with hepatic fibrosis from schistosomiasis in Jiangxi Province
Objective To analyze the epidemiological characteristics in the extant patients with hepatic fibrosis result-ing from schistosomiasis in Jiangxi Province for scientific basis to precisely manage and treatment this group of pa-tients.Methods The basic information,including the gender,age,education level,occupation,endemic type and epi-demic category of schistosomiasis,were collected from the liver fibrosis patients in Jiangxi Province in 2021.The liver fibrosis was graded according to B-ultrasound examination,and then the data were descriptively analyzed concerning the characteristics of temporal,regional and population as well as the severity of hepatic fibrosis.Results In 2021,there were 17 575 patients with liver fibrosis from schistosomiasis in Jiangxi Province.The average age was(64.9±12.6)years,and the male to female ratio was 1.45:1.The education level was mainly junior high school and below(96.83%,17 017/17 575),and the occupation was mostly farmers(90.09%,15 833/17 575).The cases were primarily distributed in areas under transmission control,including Jiujiang City(7 546 cases),Shangrao City(7 072 cases)and Nanchang City(2 192 cases).The proportion of patients with gradeⅠ,grade Ⅱ and grade Ⅲ liver fibrosis was 36.03%(6 333/17 575),52.38%(9 206/17 575)and 11.58%(2 036/17 575),respectively.The liver fibrosis grades of patients in the marshland and hilly endemic areas were mainly grade Ⅱ,accounting for 46.40%(4 004/8 630)and 58.16%(5 202/8 945),respectively.Hepatic fibrosis of grade Ⅱ was most seen in the transmission control and elimination areas,which ac-counted for 49.48%(4 109/8 305)and 71.19%(4 149/5 828),respectively,whereas gradeⅠpredominated in the trans-mission interuption areas(69.67%,2 398/3 442).There were significant differences in the constituent ratio of liver fibro-sis grading in patients with different epidemic types and epidemic categories(χ2=248.21,H=509.81,both P<0.05).The grade of liver fibrosis was mainly grade Ⅰ in patients aged 40 years and below,and grade Ⅱ in those over 40 years.However,grade Ⅲ fibrosis was the lowest in patients of any age group,and the composition ratio of liver fibrosis grad-ing in different age groups was significantly different(H=204.89,P<0.05).Conclusion Patients with liver fibrosis re-sulting from schistosomiasis in Jiangxi Province are mainly distributed in transmission-controlled areas,and the degree of liver fibrosis is mostly gradeⅠand grade Ⅲ.These results suggest that provision with early screening and precise in-tervention in the population can effectively prevent the development of chronic schistosomiasis from advanced schisto-somiasis.

Schistosoma japonicumHepatic fibrosisEpidemiological statusJiangxi Province

李宗光、何婷婷、谢婧姿、吕尚标、胡飞、袁敏、林丹丹、李宜锋

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江西省寄生虫病防治研究所,江西 南昌 330000

日本血吸虫 肝纤维化 流行现状 江西省

江西省卫生健康委科技计划项目

202211333

2024

热带病与寄生虫学
安徽省寄生虫病防治研究所

热带病与寄生虫学

CSTPCD
影响因子:0.816
ISSN:1672-2302
年,卷(期):2024.22(1)
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