我院就诊人群华支睾吸虫感染的临床分析

目的掌握华支睾吸虫感染和患病情况的临床特点,探讨临床简便的确诊方法,指导相应的防治对策。方法对我院2007-2009年随机就诊的广东人群进行大便常规检查,并对发现华支睾吸虫卵的患者的临床资料进行统计分析。结果 56140例受检患者发现,华支睾吸虫感染1029例（1.83%）。主要临床症状为肝区疼痛486例（47.2%）、上腹疼痛297例（28.9%）、腹泻173例（16.8%）、乏力147例（14.3%）、食欲不振107例（10.4%）,主要疾病有胆囊炎462例（44.9%）、胆囊息肉213例（20.7%）、胆管壁增厚182例（17.7%）、胆石症132例（12.8%）。实验室辅助检查中,华支睾吸虫感染组的嗜酸性粒细胞比例（EOS%）及血清γ谷氨酰转肽酶活性（GGT）显著高于非感染患者组（Z=-10.837,P〈0.01;Z=-6.622,P〈0.01）和健康对照组（Z=-7.320,P〈0.01;Z=-6.920,P〈0.01）。丙氨酸氨基转移酶活性（ALT）在华支睾吸虫感染有症状组中显著高于非感染患者组（Z=-3.528,P〈0.01）和健康对照组（Z=-4.948,P〈0.01）,而在华支睾吸虫感染无症状组中与非感染患者组和健康对照组无显著性差异（Z=-1.561,P=0.119;Z=-1.834,P=0.067）。结论肝区疼痛和上腹不适是华支睾吸虫病的主要临床表现,在EOS%和GGT增高的患者中华支睾吸虫卵的检出率明显提高。

Clinical analysis of Clonorchis sinensis infection of the patients in our hospital

Objective To investigate the characteristics of Clonorchis sinensis infection and prevalence,explore the confirmation diagnostic method,and suggest strategies for the prevention and treatment.Methods Stool routine test were carried out for the patients of Guangdong province who were selected randomly in our hospital from 2007 to 2009,and analyze the clinical data of the cases who were infected Clonorchis sinensis.Results 1 029 cases（1.83%） were found infected with Clonorchis sinensis among 56 140 patients.The main symptoms were liver pain（486 cases,47.2%）,abdominal pain（297 cases,28.9%）,diarrhea（173 cases,16.8%）,fatigue（147 cases,14.3%） and loss of appetite（107 cases,10.4%）.The main disease were cholecystitis（462 cases,44.9%）,gallbladder polyps（213 cases,20.7%）,gallbladder wall thickening（182 cases,17.7%）,and cholelithiasis（132 cases,12.8%）.Compared with the healthy group and uninfected group,laboratory tests suggested that EOS%（Z=-7.320,P〈0.01;Z=-10.837,P〈0.01）,GGT（Z=-6.920,P〈0.01;Z=-6.622,P〈0.01） and ALT（Z=-4.948,P〈0.01;Z=-3.528,P〈0.01） were significantly higher in the symptomatic infection group,when ALT showed no significant different between asymptomatic infection group and the control groups（Z=-1.561,P=0.119;Z=-1.834,P=0.067）.Conclusion The rate of Clonorchis sinensis infection in Guangdong population decreased from 2007 to 2009.Liver pain and abdominal pain are the main symptoms of the infected patients.The positive detection rate of Clonorchis sinensis were high（79.6%） in those patients with higher EOS% and GGT level.