华支睾吸虫病的超声诊断价值探讨

目的对比分析850例华支睾肝吸虫病患者与未查出华支睾吸虫病声像图表现作对比,探讨超声对本病的诊断价值。方法对已确诊的850例华支睾肝吸虫病患者进行肝、胆、脾、胰超声检查,观察其声像图表现与对照组进行比较。结果华支睾肝吸虫病声像图上主要表现为肝左叶增大;肝内胆管胆管壁(二级分支)增厚、轻度扩张、回声增强、以肝左叶胆管明显;另外可出现胆囊和肝实质改变。结论华支睾肝吸虫病具有特征性的声像图表现,超声检查操作简便,可作为普查手段,对本病做出早期诊断。     

华支睾吸虫病1例报告

华支睾吸虫亦称肝吸虫,成虫寄生于人和多种哺乳动物肝胆管内,引起华支睾吸虫病,又称肝吸虫病.我院收治1例感染的华支睾吸虫病患者,报告如下. 1 病例报告 患者,男,37岁,内蒙古人.2005年1月底因无明显诱因出现上腹部持续性疼痛,放散至背部,伴有乏力、纳差症状,到当地医院就诊,行胃镜检查诊断为"慢性胃炎".自服胃药治疗,效果不佳,仍时有上腹部疼痛.     

华支睾吸虫病免疫诊断及分子生物学研究进展

华支睾吸虫病是亚洲东部的一种感染人的寄生虫病 ,主要分布在中国、日本、韩国和越南北部。传统的病原学诊断方法存在着一些弊病 ,免疫诊断抗原的提纯以及免疫诊断方法的改进则提高了诊断的敏感性和特异性 ,为华支睾吸虫病的诊断提供了科学的辅助手段。本文对华支睾吸虫病的免疫诊断抗原、诊断方法以及在分子生物学方面的研究进展作一简要综述     

山东省华支睾吸虫病及流行因素分析

山东省自1962年发现有华支睾吸虫病以来，全省先后调查证实用107个县（市，区）存在不同程度的流行，60－70年代人群感染率为1．51％，乡村感染率为1％－30％，85．7％的感染者为15岁以下少年儿童，经过多年综合防治至90年代人群感染率降至0．3％，91．60％的村感染率降至1％以下，40％的流行县未再查出感染者；81％的感染者为21岁以上成年人，80年代后，由于持续干旱少雨，75％的沟渠，坑塘已断流干涸，90％以上的河水受到污染，使华支睾吸虫中间宿主鱼，螺的生存条件和数量明显减少，鱼类感染虽比70年代下降了50多个百分点，但感染率仍在30％左右，因97．9％的人改变了生吃或半生不熟的食鱼方式而减少了机会，山东省华支睾吸虫病的流行传播条件日渐减少，其流行范围逐渐缩小，人群感染率降到历史最低水平（0．3％），基本达到控制该病的目的。     

四川省绵阳地区华支睾吸虫病自然疫源地的调查

本文报告了四川绵阳地区华支睾吸虫病自然疫源地的调查研究,结果证实11个县有9个县为华支睾吸虫病自然疫源地。人群感染率平均为10.90％(2479/27734)。各年龄组均有感染,以青少年受染较重,有别于陈祖泽等报道的广东省感染特点。查明赤豆螺和纹沿螺及19种淡水鱼类为华支睾吸虫的第一、二中间宿主,华支睾吸虫携带率前者0.19％(20/10710),后者为21.89％(366/1672)。保虫宿主感染率为45.56％(128/281)。水分地势与华支睾吸虫感染有关。提出开展疑似病区流行病学调查方法与步骤。     

安徽省华支睾吸虫病的流行概况及防治对策

华支睾吸虫病又称肝吸虫病,在我国流行至少有2300年以上的历史,是由华支睾吸虫感染引起的人兽共患病。华支睾吸虫病又是一种重要的食源性寄生虫病,人群通过生食或半生食含有华支睾吸虫囊蚴的淡水鱼虾而感染。成虫寄生在人体肝胆管内。引起胆管的一系列病理改变,晚期可发生肝硬化。一些资料不断提示华支睾虫感染与胆管上皮癌、肝细胞癌的发生有一定关系。目前,有数据显示全球华支睾吸虫感染人数大约在3500万,在我国体寄生虫病仍然是重要的公共卫生问题。我国肝吸虫病全国感染人数达到1500万。安徽地处暖温带与亚热带过度地区,气候温暖湿润,江、湖水网纵横,适宜本虫的第一、第二中间宿主以及保虫宿主生存,使人群感染机会增多。加之社会环境的变化。人们追求餐饮时尚,吃生、吃鲜的人不断增多,使安微省华支睾吸虫病的流行有扩大趋重之热。     

华支睾吸虫病高发区囊蚴感染调查

目的 了解华支睾吸虫病高发区淡水鱼中囊蚴感染情况。方法 于2016年8-10月选取某华支睾吸虫病高流行区,在养殖、零售、餐饮环节采集用于生食的鲜活淡水鱼以及生鱼片,采用酶消化法进行检测。结果 鲜活鱼样品华支睾吸虫囊蚴检出率为17.24%(10/58),其中采自鱼塘、农贸市场的样品检出率分别为24.24%(8/33)、10.00%(2/20),超市样品未检出;采自餐饮环节的生鱼片样品检出率为17.74%(11/62)。结论 在当地进食生鱼片感染华支睾吸虫病的风险较高。当地淡水鱼养殖过程卫生管理存在一定问题,需加强对养殖环境的卫生管理以及淡水鱼的检验检疫工作,应建立市售淡水鱼溯源体系,同时深入开展对群众的健康教育,提高群众的食品安全意识。     

华支睾吸虫病诊断研究进展

本文就八十年代以来有关华支睾吸虫病诊断研究的进展情况作一综述。病原学诊断从粪便或十二指肠抽取物中检出华支睾吸虫卵，或从剖腹术中找到华支睾吸虫成虫是确诊华支睾吸虫感染的可靠方法。十二指肠抽取物的检出率很高，但其操作方法复杂，并不易为一般患者所接受。不同...     

华支睾吸虫的组织化学研究

用组织化学方法观察华支睾吸虫成虫各种物质的分布和定位。结果其糖原、蛋白质、脂肪、核酸ACP、酚酶的分布与文献记载基本一致,但ACP的分布较为局限,活性低下。虫体的SDH,MDH、MAO、G-6-P、G-ATP等五种酶系首次记载,前三者的分布以皮层、皮下,睾丸、卵巢与吸盘为主,SDH和MDH的活性较MAO强,G-6-P与糖原的分布颇为一致,主要在虫体的实质组织和皮下肌层,在皮层与皮下肌层的Ca-ATP活性较强。     

华支睾吸虫病免疫诊断研究进展

华支睾吸虫病是华支睾吸虫寄生于人体肝胆管内引起,又称肝吸虫病,该病的诊断主要依靠检获虫卵,但因虫卵小或感染度轻、排卵少而易于漏诊,免疫诊断可弥补不足。随着高新技术的发展和应用,显著提高了免疫诊断的敏感性、特异性和诊断效果,其在临床辅助诊断和疫区流行病学调查中的作用越来越突出。现将近年来有关本病免疫诊断的研究进展综述如下。１　特异性抗体的检测１１　检测用特异性抗原的选择　检测抗体的特异性主要取决于所用抗原的特异性,华支睾吸虫诊断抗原的研究,大多限于粗抗原或初步纯化抗原［１］。１１１　华支睾吸…     

三种吸虫感染与胆管癌发病关系的研究进展

由华支睾吸虫(Clonorchis sinensis)、麝猫后睾吸虫(Opisthorchis viverrini)和猫后睾吸虫(Opisthorchis fe-lineus)所引起的吸虫病是严重危害人类健康的食源性寄生虫病,在亚洲地区流行较为广泛,人们通过食含有囊蚴的生鱼或虾类而感染。长期且重度感染会造成肝脏机能障碍,如胆结石和胆囊炎等。近年来,越来越多的研究表明这三种吸虫与胆管癌之间存在着病因学联系。本文对他们之间的关系及胆管癌可能的发病机制进行综述。     

Opisthorchis viverrini： The carcinogenic human liver fluke

Opisthorchiasis caused by Opisthorchis viverrini remains a major public health problem in many parts of Southeast Asia, including Thailand, Lao PDR, Vietnam and Cambodia. The infection is associated with a number of hepatobiliary diseases, including cholangitis, obstructive jaundice, hepatomegaly, cholecystitis and cholelithiasis. Multi-factorial etiology of cholangiocarcinoma, mechanical damage, parasite secretions, and immunopathology may enhance cholangiocarcinogenesis. Moreover, both experimental and epidemiological evidences strongly implicate liver fluke infection as the major risk factor in cholangiocarcinoma, cancer of the bile ducts. The liver fluke infection is induced by eating raw or uncooked fish products that is the tradition and popular in the northeastern and northern region, particularly in rural areas, of Thailand. The health education programs to prevent and control opisthorchiasis are still required in the high-risk areas.     

Roles of liver fluke infection as risk factor for cholangiocarcinoma

Several factors are known to be associated with risk of cholangiocarcinoma (CCA) and infection with the liver flukes, Opisthorchis viverrini and Clonorchis sinensis, has often been singled out as the leading risk factor in east and southeast Asia. In this review, current knowledge of their biology, life cycle, and pathogenesis of O. viverrini, and its role as a carcinogenic parasite are presented. The trends of age‐specific incidence of liver cancer in Khon Kaen, northeast Thailand are considered and compared with the prevalence profiles of O. viverrini. Potential impacts of the liver fluke control program particularly by mass drug administration (MDA) and public health education in the past and a recent drop of incidence of CCA are discussed in relation to primary prevention and control of this fatal bile duct cancer.     

广东省华支睾吸虫病流行现状调查和分析

目的了解广东省华支睾吸虫病流行现状和态势。方法在全省原63个流行县（市）按流行程度和水系流域进行分层随机整群抽样，用改良加藤厚涂片法粪检虫卵并计数。结果全省调查9个县（市）27个点13876人，华支睾吸虫平均感染率为16．42％，平均克粪虫卵数（EPG）为359。有8个县市查出感染者，其中3个县感染率超过20％。平均感染率男性18．92％，女性13．89％，差异有显著性（x^2=616．7，P〈0．01）。各年龄组均有感染，以成人感染为重（感染率19．38％～27．42％）。职业分布以渔民和商人感染最重（感染率32．69％）。结论广东省华支睾吸虫病流行范围广、感染率高，已经成为一个严重的公共卫生问题，应积极开展综合性防控工作。     

广西贵港市299例华支睾吸虫病流行病学分析

目的 了解贵港市华支睾吸虫病临床病例流行病学特点.方法 回顾性分析2009-2011年在贵港市疾病预防控制中心就诊的可疑华支睾吸虫病例.采集疑似华支睾吸虫病患者当天第一次粪便30 ～50 g,用水洗自然沉淀集卵法镜检虫卵,虫卵阳性确诊为华支睾吸虫病.用Stoll法计数克粪虫卯数(EPG),划分感染度.结果 3年共确诊299例.重度感染59例,中度感染144例,轻度感染96例.患者年龄7 ～ 80岁,其中,30～59岁年龄组病例占79.93％(239/299).男性占93.98％(281/299),个体职业者占30.10％(90/299),汉族占81.61％( 244/299),市区占64.88％ (194/299),农村占35.12％( 105/299),60％的乡镇有病例.有并发症或合并症148例,占49.50％.有食鱼生史占94.65％(283/299),从首次食鱼生至确诊时间,最短20 d,最长70年.结论 贵港市华支睾吸虫病患者以中青年男性为主,市区病例多于农村.     

中山市住院病人华支睾吸虫感染现状调查

目的以调查住院病人为基础了解中山市华支睾吸虫感染状况和流行特征。方法 2016年,以中山市23个镇区医院作为监测医院,以监测医院住院病人中在中山市居住时间超过6个月者作为监测对象,采集其粪便标本,采用改良加藤厚涂片法检查华支睾吸虫虫卵,根据中山市2016年常住人口年龄和性别构成对调查得到的华支睾吸虫感染率进行标化,对不同镇区及合并相关疾病者感染率进行分析。结果共2 667人纳入监测,镜检阳性219人,感染率为8.21%。镜检阳性人群中,男性179例,占81.74%;年龄最小4岁,最大89岁,平均(62.20±13.80)岁。经年龄和性别标化后,中山市全人群感染率为3.62%,其中男性感染率为5.46%,女性为1.53%,男性是女性的3.57倍。男、女性均呈现出年龄越大感染率越高的趋势(χ_(男性)~2=99.91、χ_(女性)~2=16.51,P均0.01)。镇区标化感染率最高为10.40%,最低为0,呈北高南低的特征。胆结石病人标化感染率为9.22%,非胆结石病人为3.40%,前者是后者的2.71倍。结论 30岁以上、患有胆结石及居住于高感染率镇区者是中山市华支睾吸虫病防控的重点人群。     

Opisthorchis viverrini: pathogenesis of infection in immunodeprived hamsters

Opisthorchis viverrini infections were established in immunologically intact and T cell deprived hamsters. T cell deprivation appeared to have no effect on worm establishment or egg production. Histopathologically, intact and deprived animals showed similar degrees of bile duct hyperplasia and periductular fibrosis, though there was a marked reduction in the intensity of the periportal inflammation in the majority of T cell deprived animals. Serum transaminase levels were significantly raised in intact animals by 25 days after infection, whilst levels remained within normal limits throughout the infection period for the majority of the T cell deprived animals. The antibody response to parasite antigens as determined by immunoelectrophoresis, was impaired in T cell deprived animals. Attempts to correlate the serological picture with transaminase levels at three time points after infection and also with the extent of periductular inflammation seen on killing, proved largely unsuccessful. These results indicate that T cell deprivation of the hamster host ameliorates the periductular inflammatory response provoked by O. viverrini in this species. It is suggested that such inflammatory responses are evoked by parasite antigens which gain access to portal tract and surrounding areas, and that such reactions are immunopathological in their outcome to the host, resulting in liver cell death and subsequent replacement of resolving inflammatory and necrotic areas with fibrotic tissue.     

Genetic and environmental determinants of risk for cholangiocarcinoma in Thailand

Cholangiocarcinoma(CCA) is a difficult cancer to diagnose in the early stage and to treat by curative resec-tion. The incidence of CCA in the northeast of Thailand is the highest in the world. To make progress in detecting a high risk group and in the prevention and detection of CCA, we have been analyzing the risk factors for CCA. Although liver fluke infection is known to be a risk factor, there are patients who are not infected with the liver fluke and not all people infected with the liver fluke will suffer from the disease. Therefore, it is of the utmost importance to analyze the risk factors and the mechanism to prevent the disease and also to detect the disease in its early stage to save patients' lives. Through collaboration among Thai and Japanese researchers, we analyzed the genetic and environmental determinants of risks for CCA. Also, we have been trying to develop methods to detect the disease in a non-invasive way. Without repeating findings reported in various reviews on CCA, we will first discuss the environmental and genetic determinants of the risks for CCA. Second, we will discuss the properties of CCA, including the etiological agents and the mechanism of cholangiocarcinogenesis, and finally, we will discuss future approaches to prevent and cure CCA from the standpoint of evidence-based medicine. We will discuss these points by including the data from our laboratories. We would like to emphasize the importance of the genetic data, especially whole genome approaches, to understand the properties of CCA, to find a high risk population for CCA and to develop effective preventative methods to stop the carcinogenic steps toward CCA in the near future. In addition, it is of the upmost importance to develop a non-invasive, specific and sensitive method to detect CCA in its early stage for the application of modern medical approaches to help patients with CCA.