联合应用血清抗体检测及胃镜引导下十二指肠液引流术诊断华支睾吸虫病体会  

Diagnostic value of serum antibody test and gastroscopy⁃guided duodenal drainage for clonorchiosis sinensis

作　　者：杨绮红 许春玲 陈玉花 谭永宜 钟海珍 叶国荣 黄素军 陈沅然 刘序友 Yang Qihong;Xu Chunling;Chen Yuhua;Tan Yongyi;Zhong Haizhen;Ye Guorong;Huang Sujun;Chen Yuanran;Liu Xuyou(Department of Gastroenterology,Guangzhou Red Cross Hospital,Medical College of Jinan University,Guangzhou 510220,China)

机构地区：[1]暨南大学医学院附属广州红十字会医院消化内科,510220

出　　处：《中华消化内镜杂志》2021年第8期638-643,共6页Chinese Journal of Digestive Endoscopy

基　　金：国家自然科学基金面上项目(81972211)。

摘　　要：目的探索可以简便锁定可疑华支睾吸虫感染者并帮助其确诊的方法。方法对可疑华支睾吸虫感染者,首先检测血清肝吸虫抗体(酶联免疫吸附试验);对抗体阳性者,再行粪便查虫卵;粪便虫卵阴性者,则建议行胃镜引导下十二指肠液引流术,从引流液中查找虫卵。结果符合条件者126例,年龄(54.14±13.33)岁(24~87岁)。引流液虫卵阳性83例,占65.87%(83/126),其中男53例,年龄(55.91±11.47)岁(30~86岁);女30例,年龄(55.87±13.85)岁(30~87岁),男女年龄差异无统计学意义(P>0.05)。126例的置管时间(T1)(3.79±1.45)min,引流时间(T2)(31.39±14.29)min,T1和T2分别在阳性组与阴性组进行比较,差异无统计学意义(P>0.05)。引流液虫卵检出率由高至低分别是肝内胆管液(76例,91.57%)、胆囊液(68例,81.93%)、胆总管液(63例,75.90%)。术中和术后无发生严重不良反应。结论联合应用血清肝吸虫抗体检测和胃镜引导下十二指肠液引流术可有效提高华支睾吸虫病的检出率。Objective To explore a fast method to identify and confirm suspected clonorchis sinensis infection.Methods For suspected clonorchis sinensis infection,the clonorchiasis serum antibody was detected first with ELISA.If the antibody was positive,the fecal examination for eggs was performed.If the fecal examination was negative,duodenal drainage under gastroscopy was recommended to detect eggs from the drainage fluid.Results A total of 126 patients met the requirements and aged 54.14±13.33(24⁃87).There were 83 cases(65.87%,83/126)with eggs positive in the drainage fluid,of which 53 cases were male,aged 55.91±11.47(30⁃86),and 30 cases female,aged 55.87±13.85(30⁃87).There was no significant difference in age between males and females(P>0.05).The time of catheterization(T1)of 126 cases was 3.79±1.45 min.The time of drainage(T2)of 126 cases was 31.39±14.29 min.There was no significant difference in T1 or T2 between the positive group and the negative group(P>0.05).The detection rates of eggs were 91.57%(76 cases)in intrahepatic bile duct drainage,81.93%(68 cases)in the bile⁃cyst juice and 75.90%(63 cases)in the common bile duct fluid.No serious adverse reactions occurred during or after the operation.Conclusion The detection rate of clonorchiosis sinensis can be effectively improved by the combination of clonorchiasis serum antibody test and gastroscopy⁃guided duodenal drainage.

关 键 词：华支睾吸虫病 血清抗体转换 酶联免疫吸附测定 引流 胃镜检查 

分 类 号：R532.23[医药卫生—内科学]