Abstract: Objective　To investigate the prevalence of comorbid chronic diseases among advanced schistosomiasis patients in Suzhou City, so as to provide insights into formulation of the scheme for medical assistance management of advanced schistosomiasis patients.  Methods　All data pertaining to survival advanced schistosomiasis patients in Suzhou City were retrieved from the Information Management Platform of Schistosomiasis (Parasitic Diseases) in Jiangsu Province as of August 19, 2024. These patients' outpatient and inpatient records from January 1, 2017, to August 19, 2024, were collected through Suzhou Municipal Health Statistics Information Center. The prevalence of comorbid chronic diseases was analyzed, and the comorbid patterns of chronic diseases were identified using cluster analysis.  Results　A total of 1 868 advanced schistosomiasis patients were enrolled in Suzhou City, with a mean age of (79.20 ± 7.17) years, and the median types of prevalent comorbid chronic diseases was 5 (interquartile range, 5). The mean age [(80.13 ± 7.09) years vs. (77.49 ± 7.02) years; t = 7.70, P < 0.001] and median types of prevalent comorbid chronic diseases [5 (interquartile range, 4) vs. 4 (interquartile range, 5); Z = 436 745, P < 0.001] were both higher among female advanced schistosomiasis patients than among male cases. The prevalence of comorbid chronic diseases was 84.96% (1 587/1 868) among advanced schistosomiasis patients in Suzhou City, and the prevalence was higher among female cases than among male cases [86.58%, (1 052/1 215) vs. 81.93% (535/653); [χ2] = 7.20, P = 0.007]. The prevalence of comorbid chronic diseases appeared a tendency towards a rise with age among male advanced schistosomiasis patients ([χ2] trend = 7.63, P = 0.006) and a decline among female patients ([χ2] trend = 10.59, P = 0.001). The prevalence of comorbid chronic diseases was higher among female advanced schistosomiasis patients at ages of 70 to 80 years than among male cases at the same age group [90.18% (459/509) vs. 80.61% (266/330); [χ2] = 14.81, P < 0.001]. The three most common comorbid chronic diseases included hypertension (67.83%), chronic gastric disorders (57.28%) and heart disease (44.00%) among advanced schistosomiasis patients in Suzhou City. The comorbidity rates of chronic gastric diseases ([χ2] = 5.33, P < 0.05), heart diseases ([χ2] = 4.15, P < 0.05), stroke ([χ2] = 10.68, P < 0.05), arthritis or rheumatic disease ([χ2] = 7.13, P < 0.05), osteoporosis ([χ2] = 39.51, P < 0.05), and memory⁃related diseases ([χ2] = 7.00, P < 0.05) were higher among female advanced schistosomiasis patients than among male cases, and the comorbidity rate of malignant tumors was higher among male cases than among female cases (10.26% vs. 7.41%; [χ2] = 4.13, P = 0.042). The cluster dendrogram showed that advanced schistosomiasis patients' comorbid chronic diseases in Suzhou City were mainly divided into three clusters: (1) hypertension, chronic gastric diseases; (2) chronic pulmonary diseases, arthritis or rheumatic diseases, osteoporosis, chronic liver diseases, heart diseases, and stroke; and (3) diabetes, sleep disorders, gallbladder diseases, overweight and obesity, atopic dermatitis, chronic kidney diseases, mental and psychological diseases, malignant tumors, asthma, and memory⁃related diseases. Conclusions　There are multiple types of comorbid chronic diseases among advanced schistosomiasis patients in Suzhou City, with high prevalence, which necessitates the implementation of effective preventive measures and interventions targeting comorbid chronic diseases among advanced schistosomiasis patients.

Key words: Advanced schistosomiasis, Comorbid chronic disease, Cluster analysis, Suzhou City

摘要： 目的　了解苏州市晚期血吸虫病（晚血）患者慢性病共病现状，为制定该市晚血患者医疗救助管理方案提供依据。方法　在江苏省血吸虫病（寄生虫病）防治信息管理平台中，收集截至2024年8月19日苏州市报告的现存晚血患者信息；此外，从苏州市卫生计生统计信息中心获取2017年1月1日—2024年8月19日上述患者门诊就诊和住院数据。分析苏州市晚血患者慢性病患病及共病情况，并运用聚类分析探索其慢性病共病模式。结果　共收集苏州市1 868例晚血患者信息，患者平均年龄（79.20 ± 7.17）岁，慢性病中位患病种数为5（5）种。女性晚血患者平均年龄高于男性［（80.13 ± 7.09）岁vs.（77.49 ± 7.02）岁; t = 7.70，P < 0.001］，且女性慢性病中位患病种数多于男性［5（4）种 vs. 4（5）种; Z = 436 745，P < 0.001］。晚血患者慢性病共患率为84.96%（1 587/1 868）；女性患者慢性病共患率（86.58%，1 052/1 215）高于男性（81.93%，535/653），差异有统计学意义（[χ2] = 7.20，P = 0.007）。随年龄增长，男性晚血患者慢性病共患率呈上升趋势（[χ2]趋势 = 7.63，P = 0.006），女性患者呈下降趋势（[χ2]趋势= 10.59，P = 0.001）。70～< 80岁组女性晚血患者慢性病共患率（90.18%，459/509）高于同年龄组男性患者（80.61%，266/330），差异有统计学意义（[χ2] = 14.81，P < 0.001）。苏州市晚血患者慢性病共患率居前3位的依次为高血压与其他疾病（67.83%，1 267/1 868）、慢性胃部疾病与其他疾病（57.28%，1 070/1 868）和心脏病与其他疾病（44.00%，822/1 868）。女性晚血患者慢性胃部疾病、心脏病、脑卒中、关节炎或风湿病、骨质疏松和记忆相关疾病与其他疾病的共患率均高于男性患者（[χ2] = 5.33、4.15、10.68、7.13、39.51、7.00，P均< 0.05），但男性晚血患者恶性肿瘤与其他疾病的共患率高于女性患者（10.26% vs. 7.41%; [χ2] = 4.13，P = 0.042）。慢性病共病树状聚类图显示，苏州市晚血患者慢性病主要聚成如下3簇：① 高血压、慢性胃部疾病；② 慢性肺部疾病、关节炎或风湿病、骨质疏松、慢性肝脏疾病、心脏病和脑卒中；③ 糖尿病、睡眠障碍、胆道疾病、超重和肥胖、特应性皮炎、慢性肾脏疾病、精神和心理疾病、恶性肿瘤、哮喘和记忆相关疾病。结论　苏州市晚血患者慢性病共病种类多、共患率高，需采取有效的预防和干预措施。

关键词: 晚期血吸虫病, 慢性病共病, 聚类分析, 苏州市