粪便中日本血吸虫卵的分布

本文通过对５例阳性病人３ｄ全粪的研究，发现日本血吸虫卵在粪便中的分布具有聚集性，虫卵主要分布在粪便的表层及头端，从表面至内部及从头至尾部虫卵数有逐渐减少的趋势。随着时间的不同粪便中的虫卵计数亦有变化；又通过对４４例阳性病人的同一粪样同时制Ｋａｔｏ片１０张，结果显示随着检查次数的增加，几何均数的变化并不明显，可认为虫卵在粪便的局部是呈随机分布     

应用斑点ELISA检测华支睾吸虫病患者循环抗原的研究

用斑点ＥＬＩＳＡ检测１４０例粪检虫卵阳性的华支睾吸虫病人血清中的循环抗原（ＣＡｇ），阳性率为９７．１％。在１００例正常人和１０２例其它７种寄生虫病人中，有１．０％假阳性和２．０％轻度交叉反应。对６６例华支睾吸虫病人经吡喹酮治疗后１～２月进行ＣＡｇ复查，有２９例（４３．９％）转为阴性，即使仍保持阳性反应者，其反应强度亦有明显降低。用本法进行流行病学调查，获得较满意的结果，检测血清中ＣＡｇ与粪便中虫卵阳性和阴性总符合率高达９５．５％。     

曼氏血吸虫病人的虫体密度与产卵力的关系

Medley和Anderson(1985)对Cheever 1968年发表的103例曼氏血吸虫病尸检材料进行分析后认为,曼氏血吸虫病人体内虫体数与粪中排出虫卵数有相依关系,即粪检中每对虫体所排虫卵数随着配对虫数的增加而减少。对此,Cheever提出如下意见:Medley和Anderson分析时略去了10例其虫卵计数被认为是“非定量的”病人。这10例病人体内检获的平均配对虫体数为5.8对,每对虫体每克粪便的平均虫卵数为3.0,即比Medley和Anderson从其余病人得出的曲线推算出的数值少8倍。故仅仅分析粪便中有虫卵的轻度感染病人,曲线将受明显影响。Lumey和Vermund(待发表资料)最近重新     

日本血吸虫(中国大陆株)感染小鼠粪虫卵的分布特征

目的以数学模型描述感染日本血吸虫(中国大陆株)的小鼠阳性粪便虫卵数的时间动力学分布规律。方法自血吸虫感染小鼠后第5周至第11周,每周收集24 h粪便1次,并计数每克粪样中的虫卵数(EPG)。EPG的均数m≥400时,利用回归方程lg(v)=a+blg(m)的回归系数b是否接近2,来判断粪虫卵是否服从负二项分布。结果剔除EPG为0的结果,组内小鼠EPG在同一时间点上呈正态分布。取各时间点小鼠粪EPG的均值m,分别构建C57BL/6与BALB/c小鼠阳性粪样便EPG的回归方程,显示全部阳性粪样的方程系数b分别为1.72和1.39,连续7次阳性鼠粪EPG的回归方程系数b分别为1.71和1.26。结论实验室感染日本血吸虫的C57BL/6与BALB/c小鼠,粪虫卵的时间的分布均可以负二项分布来描述,但C57BL/6小鼠粪虫卵数随时间分布的拟合优度高于BALB/c。     

日本血吸虫感染的虫卵计量变化研究

目的了解粪中日本血吸虫卵计量变异特征。方法对清溪二村民连续7次收集粪便，用改良Kato法涂片2张;对44倒粪检阳性者，再涂片10张。结果一村粪检累计检出率从单次42.38％增加到7次的68.26％，二村从17.02增加到35.98％。虫卵在同一粪便中的分布并非完全随机。结论改良Kato法的敏感性与人群感染度及粪便取样部位有关;个体内虫卵计量变异，可用负二项分布来描述其特征。     

对Kato—Katz法在检测粪便血吸虫卵中的一些看法

近年来,Kato—Katz厚粪片法以其简便易行,直接取粪计数,虫卵遗失少等优点被广泛应用于肠道蠕虫卵尤其是日本血吸虫卵的现场调查和实验室检验之中。但国内对该法运用结果,笔者有如下的一些看法。现探讨如下: 一、研究表明,血吸虫卵在粪便中的分布十分复杂。一般情况下,其分布有一定独立性,较近似于Poisson分布,而经调匀后的粪便中该虫卵的分布一般符合Poisson分布。因此,国内尼龙袋集卵     

Kato-Katz法2送6检结合粪孵法用于血吸虫病现场筛查

目的探讨敏感性、准确性较高的血吸虫病病原学检查新方法。方法以血吸虫病流行区湖北省武汉市汉南区捞子湖村居民为对象,连续2d每天收集1次新鲜粪便样本,并采用加藤厚涂片法（Kato-Katz法）顺序制作6张涂片,检测粪便中血吸虫卵（2送6检）;对检测阴性者再采用尼龙绢集卵孵化法对粪便样本复检,进行阳性检出率和克粪虫卵数（EPG）值的比较。同时收集相关的流行病学基础资料。结果 Kato-Katz法共检测562人,阳性67例;对Kato-Katz法检测阴性的495人进行粪孵法复检,阳性6例;两法检出总阳性者73例。以阳性病人73例计算,Kato-Katz法1送3检累计阳性为48例,累计阳性率为65.8%,漏检率为34.25%,2送6检累计阳性为67例,累计阳性率为91.8%,漏检率为8.22%,随着检测次数的增加,阳性检出率逐渐升高。6次累计阳性率比单次平均阳性率提高53.50%。病人EPG几何均数1～6片分别为61.12、31.92、23.71、20.88、19.35和18.83,显示涂片数较少时病人EPG偏高,病人EPG的准确性随涂片数增加而提高。结论为获得较高的血吸虫病检出率和准确的人群感染度,Kato-Katz法2送6检结合粪孵法值得应用。     

Dot—ELISA检测循环抗原在急性血吸虫病中的临床应用

1990年7～10月,我所收治急性血吸虫病(急血)97例,采用单克隆抗体(McAb)斑点酶联试验(Dot—ELISA)检测循环抗原(SCA)70例,应用于临床诊断及疗效考核。 材料与方法 一、待测血清:“急血”病人血清70份,取自本所住院病人。其中粪便单项检查阳性血清25份,双项检查粪阳及IHA(或COPT)阳性血清30份,IHA(或COPT)单项检查阳性血清13份,症状、体征阳性血清2份。经治疗6个月后病人血清40份。 二、粪检及IHA、COPT测定方法:均按血防手册方法。以粪检(1送1检)为依据,以IHA(冻干诊断血球由人民解放军163医院提供,批号:910406)、COPT(虫卵抗原由本所自制干虫卵粉,批号:9102)作对照。     

粪类圆线虫病稀有的临床症状

除粪类圆线虫病在粪便里找到幼虫外,对怀疑有肠道线虫感染的一般诊断方法是在粪便里找到虫卵。本文作者很详细地描述了2例具有很不典型的肝、肾机能不全的患者。用十二指肠插管法检出了粪类圆线虫的幼虫;作者注意到,这个方法对于有损及肝、胰或十二指肠的症状和体症的病人是有用的。作者认为他们所见到的2个     

云南省血吸虫病流行区无害化卫生厕所效果评价

目的了解血吸虫病流行区卫生厕所改造状况，评价其对粪便处理的卫生效果。方法在2个县（市）4个血吸虫病流行村分别随机抽取30座已改造的卫生厕所，按照《粪便无害化卫生标准》相关要求，检测卫生厕所贮粪池粪液、出口粪液的大肠菌群和寄生虫卵进行分析。结果共检测卫生厕所120座，出口粪液大肠菌值合格率为93．33％，蛔虫卵死亡率为100％，寄生虫卵沉降合格率为92．50％。结论血吸虫病流行区建设或改造的卫生厕所，对粪便中的大肠菌群和寄生虫卵有较好的杀灭作用，但应加强管理，提高改厕覆盖率，使其发挥更大效益。     

Distribution and preservation of Schistosoma mansoni eggs in stools

Thirty-eight stool samples were preserved with sodium azide, 5 mg g-1 of stool. Results show that after 12 weeks, all the samples with S. mansoni eggs remained positive with good egg morphology. Egg counts show an average decrease of about 20%. Given the logistic advantages provided by using a small quantity of dry preservative this method is acceptable for mass prevalence surveys where sensitivity is not critical. The distribution of eggs in the stool was studied in 10 samples. Results showed no significant differences between centre and surface of the stools.     

全国血吸虫病监测点现场病原学检测效果及质控评估

目的 了解全国血吸虫病监测点血吸虫病病原学检测能力,评价尼龙绢集卵孵化法现场检测效果,为建立血吸虫病监测点病原学诊断质控体系提供参考依据。方法 收集2011年全国12个省（市、自治区）81个血吸虫病监测点血检阳性居民病原学检查资料,分析Kato?Katz法和尼龙绢集卵孵化法的检测效果;由各监测点采用单盲法检测国家血吸虫病诊断参比实验室统一提供的血吸虫虫卵孵化质控样本,比较两种病原学诊断方法检测的符合率、误检率和漏检率。结果2011年全国81个血吸虫病监测点共采用Kato?Katz法和尼龙绢集卵孵化法检测3 780例血检阳性居民,查出双阳性127例,双阴性3 513例,总符合率为96.30%;其中Kato?Katz法检出阳性173例,阳性率为4.58%;尼龙绢集卵孵化法检出阳性221例,阳性率为5.85%。两法共检出阳性267例,总阳性检出率为7.06%,较单纯Kato?Katz法阳性检出率提高54.15%（ χ2 = 21.32,P < 0.01）。2012年全国12个省（市、自治区）80个血吸虫病监测点共检测病原学孵化质控样240份（阳性160份,阴性80份）,检出阳性样本105份,阴性样本67份,总符合率为71.67%（172/240）,总漏检率为34.38%（55/160）,其中强阳性样本漏检率为32.50%（26/80）,弱阳性样本漏检率为36.25%（29/80）,阴性误检率为16.25%（13/80）。安徽、湖北、湖南、江苏、江西和四川6省血吸虫病监测点对病原学孵化质控样本检出率分别为61.11%、80.00%、77.08%、90.48%、58.33%和59.26%,差异有统计学意义（χ2 = 14.27,P < 0.05）。结论 尼龙绢集卵孵化法现场检测血吸虫病效果显著优于Kato?Katz法,但大多数血吸虫病监测点对尼龙绢孵化法的掌握程度较低,需进一步加强血吸虫病诊断技术培训。     

Variation in weight of stool samples prepared by the Kato-Katz method and its implications

We investigated both the extent of the variation in weight of stool samples prepared by the Kato–Katz method and its influence on egg counts and commonly used group parameters of infection derived from them. In a first study group of 795 people, the total mean weight of stool aliquots, prepared with templates designed to contain 28.3 mm³, was 23.0 mg with 95% of the individual values lying between 12.0 and 34.0 mg. Minimum and maximum values were 2.4 and 49.5 mg, respectively. Frequency distributions of the individual weights, in series of slides prepared by different laboratory assistants, showed significant differences. In a second study group of 199 people, duplicate series of slides were prepared and variations in the weight of examined stool were related to variations in egg count. The correlation between repeated individual sample weights in this series was poor, but the correlation between egg counts was good. This was translated, at aggregate level, in very similar classifications in egg count categories. This classification was also hardly influenced by the choice of the conversion factor to transform egg counts per slide into eggs per gram. At the individual level, the variability in egg counts far outweighed the variability in sample weight and was not clearly related to it. We therefore concluded that variations in weight of examined stool are considerable, but account for only a minimal part of the important egg count fluctuations generally observed.     

Parasep?粪便离心管法检测血吸虫虫卵效果

目的 目的 探讨Parasep?粪便离心管法在血吸虫病病原学检测中的应用效果。方法 方法 选择湖北省江陵县2个血吸 虫病流行村6～65岁居民为研究对象, 采用改良加藤厚涂片法 （Kato?Katz法）、 尼龙绢集卵孵化法和Parasep?粪便离心管 法进行病原学平行检测, 对检测结果进行比较分析。结果 结果 2个村共检测803人, 共查出血吸虫虫卵阳性15例, 平均粪 检阳性率为1.87%。其中Kato?Katz法、 尼龙绢集卵孵化法和Parasep?粪便离心管法粪检阳性率分别为0.75%、 1.49%和 1.12%, Parasep?粪便离心管法的检出率是Kato?Katz法的1.49倍。2个村Kato?Katz法的漏检率最高, 分别为57.14%和 62.50%, 尼龙绢集卵孵化法最低, 分别为14.29%和25.00%。Parasep?粪便离心管法可使显微镜下虫卵形态不变, 卵内毛 蚴结构清晰, 容易辨认。结论 结论 在血吸虫病低度流行区, Parasep?粪便离心管法可作为日本血吸虫病病原学诊断的方法。     

The intensity and effects of infection with Schistosoma mansoni in a rural community in northeast Brazil.

The intensity of infection with Schistosoma mansoni and its effects were investigated in a defined population living on three contiguous fazendas (subcounties) in a nonmalarious area of northeast Brazil near Salvador, Bahia. Quantitative stool egg counts (Bell technique) were performed on 363 of 417 individuals (90%) of all ages; physical examinations were done on 294 of 357 individuals (82%) 5 years of age and older. The maximum increase in prevalence was observed between the 1- to 4- and 5- to 9-year age groups, while the maximum increase in fecal egg count occurred between 5- to 9- and 10- to 14-year age groups. Highest egg counts were observed in the 10- to 14-year age group (geometric mean of 301 eggs per ml of stool) while the maximum prevalence (100%) was in the 20- to 24-year age group. In the fazenda with the lowest quantitative egg counts the age specific prevalence rates increased more slowly than in the fazendas with higher egg counts. In the study group nearly 50% of the total fecal egg output was accounted for by 22 individuals (6%) who had a mean age of 12.6 years. Egg counts for this selected group were all over 800 eggs per ml of stool with a mean of 1,514 eggs per ml of stool. In children under 15 years of age, the frequency of hepatomegaly and splenomegaly varied directly with the egg count; further, the degree of hepatomegaly was directly correlated with increasing egg counts. No splenic enlargement was noted in children not excreting eggs. In adults, on the other hand, neither splenomegaly nor hepatomegaly could be directly related to schistosomal infection per se. In children, neither the presence of infection with S. mansoni nor its intensity was reflected by altered anthropometric measurements. In the one fazenda tested the frequency of stools positive for occult blood correlated with increasing S. mansoni egg counts.     

The effect of the number of stool samples on the observed prevalence and the infection intensity with Schistosoma mansoni among a population in an area of low transmission

Examination of faecal material by Kato Katz (KK) technique is a widely used approach for the diagnosis of intestinal schistosomiasis, particularly in epidemiological surveys. However, this technique lacks diagnostic sensitivity in individuals with low infection intensity or in low endemic areas. In the total population (TP) of 1265 individuals prevalence and infection intensity were established by examining two KK slides. A representative subset of 305 individuals, denominated experimental group (EG), was defined to assess the comparative advantage of an increased sampling effort using the KK technique. In addition stools of the participants of the EG were examined by the formol ether centrifugation technique. The proportion of all positive stool examinations detected by both methods among the experimental group served as reference value for prevalence (diagnostic 'gold' standard). Prevalence of schistosomiasis among TP based on two KK slides was 12.5%. Prevalence among the EG varied from 13.8%, based on one KK slide, over 27.2 based on 10 KK slides of three stool samples to 35.4% as value for the diagnostic 'gold' standard. The comparison of values for prevalence, stratified by age, revealed significant elevated numbers for all age groups, and interestingly, an extension of the highest prevalence levels until an age of 50 years. The overall infection intensity in eggs per gram (epg), calculated as geometric mean, was 83 epg for the TP based on one KK slide, 78 epg for the GE based on one KK slide and 28 epg based on 10 KK slides of three stool samples. In summary our data demonstrate that control programmes based on the examination of a single KK slide, as it is the case in Brazil, tend to underestimate significantly the prevalence and overestimate infection intensity. This applies especially for low endemic areas, where the efficacy and cost-effectiveness of such programmes become questionable. Our data also indicate that the possible solution of this problem lies in targeted mass treatment including age groups with the highest proportions of those infected. This will give high sensitivity together with sustainability and suitability under field conditions.     

日本血吸虫病常用诊断方法应用价值的评估IIHA筛查法对血吸虫病疫区人群感染率的评价

目的分析IHA筛查法评估血吸虫病疫区人群感染率的可靠性。方法在江西省鄱阳湖血吸虫病疫区选取一个村的居民为研究对象，对每位对象收集2次新鲜粪便标本各制作6张Kato片（2粪12片）进行病原学检测，同时采用IHA法进行血清学定量检测，分析常规1粪3张Kato片的阳性检出率与漏检率、IHA的诊断效率及IHA与Kato-Katz法结果的相关性。结果3张Kato片漏检率达19．7％～66．1％，1粪较2粪漏检率为23．0％。IHA的敏感度和特异度分别为69．6％、89．4％，与Kato-Katz法的总符合率为86．7％。IHA的阴性预测值为96．8％，但阳性预测值较低（36．8％），阳性漏检率高达30．4％；IHA筛查法对试点区人群感染率估算的漏检率达35．8％。结论IHA筛查法对疫区人群实际感染率估算有较大的偏差，IHA作为筛查工具仍需提高其敏感性和特异性，IHA阳性阈值有待进一步探讨。     

Efficacy of mirazid in comparison with praziquantel in Egyptian Schistosoma mansoni-infected school children and households

This trial investigated the anti-schistosomal activity of mirazid in comparison with that of praziquantel in Schistosoma mansoni-infected Egyptian patients. The sample population was composed of 1,131 individuals (459 school children and 672 household members). Screening for S. mansoni was conducted using the standard Kato Katz technique. Four slides from a single stool sample were examined before treatment, and four slides per sample from stool samples obtained on three consecutive days were examined post-treatment. All positive eligible subjects were randomly assigned into two groups, the first received mirazid at a dose of 300 mg/day for three consecutive days, and the second received praziquantel at a single dose of 40 mg/kg. All treated subjects were examined 4-6 weeks post-treatment. Mirazid showed low cure rates of 9.1% and 8.9% in S. mansoni-infected school children and household members, respectively, compared with cure rates of 62.5% and 79.7%, respectively, in those treated with praziquantel. Therefore, we do not recommend mirazid as an agent to control schistosomiasis.     

改进改良加藤厚涂片法诊断血吸虫病的研究

目的将尼龙绢集卵法与改良加藤厚涂片法（简称加藤法）相结合加以改进,进行实验室预试验和现场研究。方法实验室设计制作EPG（每克粪虫卵数）分别为4、8、16、24、48、96六种阳性粪便标本,现场选定低、中、高三个不同感染率的流行村各粪检居民200人,对各EPG组和每人份粪便按30g、5g、41．7mg粪量分组,分别用改进法和加藤法作粪检,进行阳性检出率和EPG值的比较。结果改进法两组阳性检出率均高于加藤法,EPG在4时,加藤法未能检出,漏检率100％,EPG在24及其以上（新鲜血吸虫卵）两法检出率相等,检出EPG值相近。低度流行村,加藤法未能查出病人,改进法两组均可查出,且30g组优于5g组。中、高度流行村,加藤法检出阳性率渐增,但仍低于改进法;检出阳性病人EPG值,改进法的30g组与加藤法相近。结论EPG在24以下及低度流行区不宜用加藤法查病,采用改进法较好,EPG在24以上和中、高度流行区查病,两种方法均可采用。     

A comparison of the filtration, concentration, and thick smear techniques in the diagnosis of Schistosoma bovis infection in cattle and goats

The syringe and the modified Bell filtration techniques, the cellophane faecal thick smear (Kato/Katz) and Teesdale (sandwich) smear techniques, and the formol-ether concentration technique were compared for efficiency for detection of eggs of Schistosoma bovis in faeces from cattle and goats. Both filtration techniques were highly effective as revealed by high sensitivity and mean egg counts. However, efficiency declined markedly using formalin-fixed faecal material. The efficiency of the Teesdale technique was comparable to that of the filtration techniques, whereas the efficiency of the Kato/Katz technique in goats and the formol-ether concentration technique in cattle was markedly lower. The ease of performance combined with the high sensitivity make the syringe filtration and the Teesdale techniques recommendable for field diagnosis of schistosomiasis in domestic stock.