脑型并殖吸虫病2例报告及文献复习

目的报道2例脑型并殖吸虫病,并作文献复习,以供临床医生参考。方法复习近期诊断治疗的2例脑型并殖吸虫病临床资料并摘要查阅"中国知网"与Medline,选择近年发表的有关脑型并殖吸虫病的文献予以综述。结果 2例患者有癫痫或发作性抽搐等表现,头颅MRI或CT呈炎性肉芽肿或与"脑囊虫病"影像相似表现,并殖吸虫特异性血清抗体阳性,经吡喹酮抗虫治疗后病情短期内明显改善。文献复习显示儿童脑型并殖吸虫病的报道较多,误诊病因多为结核性脑膜炎、颅内占位性病变、原发性癫痫等。误诊的主要原因为对流行病学资料不够重视。吡喹酮治疗效果良好。结论临床上应充分重视脑型并殖吸虫病的诊治。

Two cases of cerebral paragonimiasis and literature review

Objective To report 2 cases of cerebral paragonimiasis and review the literature for the reference of physicians. Methods The clinical data of 2 cases of cerebral paragonimiasis were reviewed and abstracted, and the literature about cerebral paragonimiasis was also reviewed from CNKI and Medline databases. Results The 2 patents with cerebral paragonimiasis had the symptoms of falling sickness or twitch. The MRI or CT imaging was granulomas or similar to cerebral cysticercosis in the brain. The serum antibodies to Paragonimus were positive. The 2 patients were cured with praziquentel. The literature review showed that the reported cerebral paragonimiasis in the children was more than that in the adults. The diseases misdiagnosed as cerebral paragonimiasis were tubercular meningitis, occupied pathological changes in the brain, and epilepsy, etc. The main cause of misdiagnosis was the neglect of the epidemiology data. The therapeutic effect of praziquentel on cerebral paragonimiasis was good. Conclusion Physicians should pay more attention to cerebral paragonimiasis.