浙江省1例输入性罗阿丝虫病的诊断与病原学鉴定  

Diagnosis and etiological identification of an imported case of loiasis

作　　者：张家祺 阮卫[1] 王笑笑[1] 陈华良[1] 叶亚君 赵明 姚立农[1] ZHANG Jia-qi;RUAN Wei;WANG Xiao-xiao;CHEN Hua-liang;YE Ya-jun;ZHAO Ming;YAO Li-nong(Zhejiang Provincial Centre for Disease Control and Prevention,Hangzhou,Zhejiang 310051,China;Lin’an District Center for Disease Control and Prevention)

机构地区：[1]浙江省疾病预防控制中心,浙江杭州310051 [2]临安区疾病预防控制中心

出　　处：《中国病原生物学杂志》2021年第4期446-449,共4页Journal of Pathogen Biology

基　　金：浙江省医药卫生科研基金项目(No.2020PY038)。

摘　　要：目的对浙江省1例输入性罗阿丝虫病患者进行诊断与病原学分析。方法对患者眼科手术取出的线虫进行形态学、免疫学及分子生物学检测,收集患者临床资料并进行流行病学调查。结果患者手术中取出的虫体,肉眼及镜检观察无法判断虫种;虫体DNA经PCR扩增,产物序列与罗阿丝虫(GenBank登录号DQ995497.1)的ITS1基因相似性为100%。患者外周血中查见微丝蚴,提取DNA后进行PCR,扩增片段序列与罗阿丝虫(Gen Bank登录号:DQ995497.1)ITS1的相似性为100%。血清丝虫IgG4抗体检测呈弱阳性。结论根据流行病学史、临床特征,结合形态学、免疫学和分子生物学检测结果,患者确诊为输入性罗阿丝虫病例。Objective To diagnose a case of imported loiasis in an African student in Zhejiang Province and to analyze its etiology. Methods Morphological identification of the nematode and microfilariae were performed under a microscope. An ELISA kit was used to detect IgG4 antibodies against filariae. The tail tissue of the nematode and the patient’s blood were collected for DNA extraction and amplification with PCR. Clinical data on the patient were collected and an epidemiological investigation was conducted. Results In August 2019, the patient(a student from Equatorial Guinea) felt pain in his left eye without obvious cause. Pain gradually worsened, and a cord-like object wriggled under the skin of the left upper eyelid. A nematode was removed under the conjunctiva of the left eye during ophthalmic surgery. The nematode was white-gray and encased in a transparent sheath, and it was about 340 mm×0.5 mm in size. Microfilariae were found in the patient’s peripheral blood. DNA was extracted and amplified using PCR. The sequence of the PCR product had 100% similarity to that of ITS1 of Loa loa(GenBank Accession No: DQ995497.1). Serum was weakly positive for IgG4 antibodies against filariae. Conclusion Based on the clinical characteristics along with the results of morphology, immunology and molecular biology, this case was diagnosed as loiasis.

关 键 词：罗阿丝虫 微丝蚴 人体寄生虫 

分 类 号：R383.16[医药卫生—医学寄生虫学]