一例钩虫感染重度缺铁性贫血病例诊断分析  

Diagnosis of a case with severe iron-deficiency anemia caused by hookworm infections

作　　者：胡海燕[1] 崔清荣 余力 罗赛飞 葛君华[1] 裘丹红[3] HU Haiyan;CUI Qingrong;YU Li;LUO Saifei;GE Junhua;QIU Danhong(Department of Laboratory Medicine,Tiantai Center for Disease Control and Prevention,Tiantai,Zhejiang 317200,China;Tiantai County People's Hospital,Tiantai,Zhejiang 317200,China;Taizhou Center for Disease Control and Prevention,Taizhou,Zhejiang 318000,China)

机构地区：[1]天台县疾病预防控制中心检验科,浙江天台317200 [2]天台县人民医院,浙江天台317200 [3]台州市疾病预防控制中心,浙江台州318000

出　　处：《预防医学》2022年第11期1178-1180,1186,共4页CHINA PREVENTIVE MEDICINE JOURNAL

摘　　要：2021年4月25日,浙江省台州市天台县疾病预防控制中心在土源性线虫病监测工作中发现1例钩虫感染患者。该患者2020年7月24日因头晕目眩、四肢乏力至某县人民医院就诊,实验室检查红细胞2.5×10^(12)/L、血红蛋白45 g/L、嗜酸性粒细胞百分比3.4%、血清铁4.7μmol/L、铁蛋白<1μg/L,初步诊断为重度缺铁性贫血,予输血及补铁治疗,后3次复查血常规均提示嗜酸性粒细胞百分比升高。2021年4月25日采用改良加藤厚涂片法检测粪便标本检出钩虫卵,粪便试管滤纸培养法鉴定为美洲钩虫。根据现场流行病学调查和实验室检测结果,诊断为钩虫感染引起的重度缺铁性贫血。建议加强农村地区居民寄生虫病防治知识健康教育,提升医疗机构寄生虫病诊疗水平,避免误诊漏诊。On April 25,2021,a case with hookworm infections was identified during the surveillance of soil-borne nematodiasis by Tiantai Center for Disease Control and Prevention,Taizhou City,Zhejiang Province.The patients was admitted to a county people's hospital due to dizziness and limb weakness on July 24,2020.Laboratory tests showed 2.5×1012/L red blood cell counts,45 g/L hemoglobin,3.4%eosinophil percentage,4.7μmol/L serum iron and<1μg/L ferritin,and severe iron-deficiency anemia was initially diagnosed.Following treatment with blood transfusion and ion supplement,subsequent three routine blood tests indicated elevated eosinophil percentages.On April 25,2021,hook⁃worm eggs were detected in stool samples using Kate-Katz technique,and Necator americanus was identified with the test-tube filter-paper culture method.Severe iron-deficiency anemia caused by hookworm infections was diagnosed based on field epidemiological surveys and laboratory tests.The health education pertaining to parasitic disease control knowledge among residents and the diagnosis and treatment of parasitic diseases in medical institutions are recommend⁃ed to be improved in rural areas to avoid misdiagnosis and missing diagnosis.

关 键 词：钩虫病 缺铁性贫血 农村 

分 类 号：R532.1[医药卫生—内科学]