并殖吸虫病的流行病学、临床学及血清学诊断的研究  

Studies on epidemiology,clinical aspects and serodiagnosis of paragonimiosis

作　　者：崔晶[1] 王中全[1] 毛福荣[1] 晁萍[1] 郭茂峰[1] 尹光辉[1] 晋雪香[1] 

机构地区：[1]郑州大学医学院寄生虫学教研室,河南郑州450052

出　　处：《河南医学研究》2002年第2期166-169,共4页Henan Medical Research

基　　金：河南省科学技术厅科技攻关计划项目 (99l170 411);河南省教育厅自然科学基础研究项目 (97310 0 0 8)

摘　　要：目的 :研究并殖吸虫病在河南省的流行病学特点、临床特征及其血清学诊断方法。方法 :对我们诊治的 5 0例并殖吸虫病患者进行病例分析 ;在南阳地区进行本病的流行病学调查 ;应用斯氏狸殖吸虫成虫冰冻切片抗原间接荧光抗体试验 (IFAT)对本病患者血清进行抗并殖吸虫抗体的检测。结果 :本病在河南省主要分布于西部和西南部的山区及丘陵地带 ,在 5 0例患者中儿童占 6 2 % ,男性多于女性 ,夏季为本病的高发季节 ,主要因生食或半生食溪蟹和饮生溪水而感染。胸肺型、皮下包块型、脑型、腹型及心包型患者分别占本病的 5 0 %、32 %、2 2 %、18%及 12 %。嗜酸性粒细胞 (Eos)增多者占 72 %。痰、粪检查均未发现虫卵 ,皮下包块活检后病理检查主要表现为嗜酸性肉芽肿和隧道样改变。南阳地区居民并殖吸虫的感染率为 16 .3% ( 4 2 /2 5 7) ,感染率随年龄增长而下降 ;当地河南华溪蟹的囊蚴感染率为 40 % ( 4 8/12 0 ) ,实验感染大鼠后获得斯氏狸殖吸虫成虫和虫卵。应用IFAT对 5 0例本病患者血清检测时抗体阳性率为 10 0 % ,2 0例丝虫病、30例包虫病、9例结核病及 2 3例健康人血清均为阴性反应 ,抗原片在 -2 0℃可保存 5年而不丧失抗原活性。结论 :河南省的并殖吸虫病主要因斯氏狸殖吸虫所致 ,患者在临床上主要表现为幼虫?Objective: To study the epidemiological and clinical features of paragonimiasis in Henan province,and the serodiagnostic methods.Methods: Fifty cases with paragonimiasis were analysed.Epidemiological investigation was carried out in Nanyang area.Indirect fluorescent antibody test (IFAT) with frozen sections of P.skrjabini adult worms as antigen was used to detect the anti-Paragonimus antibodies in sera from the patients.Results: Paragonimiasis in Henan province was mainly distributed in the western and southwestern mountain areas and hilly lands.Among 50 cases children took 62% of the patients.This disease was more common in males than in females.The incidence of disease is high in summer.The patients were acquired mainly by ingesting raw or undercooked freshwater crabs and drinking raw stream water. The incidence of thoracopulmonary,subcutaneous nodule,cerebral,abdominal and pericardial lesions was 50%,32%,22%,18% and 12% respectively.74.1% of cases showed eosinophilic.The pathological examination of subcutaneous nodule biopsy specimen mainly demonstrated eosinophilic granuloma and tunnel-like lesions.The overall prevalence of Paragonimus infection among the inhabitants in Nanyang area was 16.3% (42/257).Prevalence rate tended decreased with age.The commonest crab recovered was Sinopotamon honanses with 40%(48/120) of crabs infected with metacercariae.The P. skrjabini adult worms and ova were obtained from the rats experimentally infected with metacercariae collected from the crabs.Specific anti-Paragonimus antibodies were detected in all sera of 50 cases by IFAT.All of the sera from the patients with filariasis(20 cases),echinococcosis (30 cases),tuberculosis (9 cases) and healthy controls(23 cases) were negative.The antigenic sections could be stored at -20℃ for 5 years without losing of the antigenicity.Conclusion: Paragonimiasis in Henan province was mostly caused by P.skrjabini.The main manifestations of the patients were larva migrans.Eggs were scarcely found in sputum of feces.IFAT is highly senstitiv

关 键 词：并殖吸虫病 流行病学 临床学 血清学 诊断 间接荧光抗体试验 

分 类 号：R532.230.4[医药卫生—内科学]