肺吸虫脑病10例临床分析  

Clinical analysis of 10 cases of cerebral paragonimiasis

作　　者：肖科 赵东霞 王映伟 邹永胜 XIAO Ke;ZHAO Dongxia;WANG Yingwei;ZOU Yongsheng(Department of Infectious Diseases,Department of Tuberculosis,Infection and Immunity Laboratory,Affiliated Hospital of Southwest Medical University,Luzhou Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院感染病科,结核病科,感染与免疫实验室,四川泸州646000 [2]西南医科大学附属医院核医学科,四川泸州646000

出　　处：《中国感染与化疗杂志》2021年第1期52-55,共4页Chinese Journal of Infection and Chemotherapy

基　　金：四川省重点学科(传染病学)建设项目基金(SZD0421)。

摘　　要：目的了解肺吸虫脑病的临床表现、实验室检查结果、治疗及预后,提高临床诊治能力。方法收集2014年1月-2018年12月西南医科大学附属医院收治的肺吸虫脑病病例,统计分析患者的临床资料。结果10例患者男8例,女2例,年龄3~12岁,中位年龄7.8岁,其中8例有确切生食或半生食流行区肺吸虫中间宿主及其制品的流行病学史。临床表现以神经系统障碍为主,9例外周血嗜酸粒细胞数升高,10例肺吸虫抗体阳性,头颅磁共振成像主要表现为脑炎型5例,血肿型3例,囊肿型2例。10例患者使用吡喹酮治疗后8例治愈,2例遗留部分神经系统功能障碍。结论肺吸虫脑病多见于儿童,临床表现不典型,需结合流行病学史及相关辅助检查诊断,首选吡喹酮治疗,多数患者预后良好。Objective To understand the clinical manifestations,laboratory tests,treatment,and prognosis of cerebral paragonimiasis for better clinical diagnosis and treatment.Methods The clinical data of patients with cerebral paragonimiasis admitted to the Affiliated Hospital of Southwest Medical University from January 2014 through December 2018 were reviewed and statistically analyzed.Results Ten patients were identified,including 8 males and 2 females.Patient age was from 3 to 12 years old(median 7.8 years).Eight patients had definite epidemiological history(such as eat the raw or half-cooked food made of intermediate host of lung fluke).Nervous system disorder was the main clinical manifestation.Eosinophils in peripheral blood increased in 9 cases.Paragonimiasis antibody was positive in 10 cases.Head magnetic resonance imaging showed encephalitis type in 5 cases,hematoma type in 3 cases,and cyst type in 2 cases.All patients were treated with praziquantel.Eight patients were cured,and 2 patients were left with neurological disorders.Conclusions Cerebral paragonimiasis is more common in pediatric patients,whose clinical manifestations are atypical.The diagnosis should be based on epidemiological history and relevant auxiliary examinations.Praziquantel is the first choice for treatment.Most patients have a good outcome.

关 键 词：肺吸虫脑病 临床特点 治疗 预后 

分 类 号：R532.2[医药卫生—内科学]