青海动物棘球绦虫感染调查研究

:1992～ 1999年分别对青海青南高原区、祁连山地和河湟谷地区及柴达木盆地三个不同地形区的家养动物和野生动物棘球绦虫的感染进行了调查研究 ,结果在终宿主动物犬、狼、狐和猫的小肠内发现细粒棘球绦虫感染 ,也在犬和狐小肠中证实存在多房棘球绦虫感染。在 4种家养的中间宿主动物绵羊、牦牛、山羊和猪体内发现细粒棘球蚴的感染 ,也在黑唇鼠兔、灰尾兔和灰仓鼠 3种野生的中间宿主动物证实存在泡球蚴的感染。显示青海两种棘球绦虫的宿主动物种类较多 ,且主要终宿主 (犬 )和中间宿主 (绵羊、牦牛 )的棘球绦虫和棘球蚴的感染率都很高。提示青海三个不同地形区内均存在细粒棘球绦虫的家养和野生食肉动物 /家养或野生食草动物之间的生活史循环链和多房棘球绦虫的家养和野生食肉动物 /野生啮齿类动物之间的生活史循环链。     

青海运物棘球绦虫感染调查研究

１９９２－１９９９年分别对青海青南高原区,祁连山地和河湟谷地区及柴达木盆地三个不同地形区的家养动物和野生动物棘球绦虫的感染进行了调查研究,结果在终宿主动物犬、狼、狐和猫的小肠内发现细粒棘球绦虫感染,也在犬和狐小肠中证实存在多房棘球绦虫感染。在４种家养的中间缩主动物绵羊、牦牛、山羊和猪体内发现细粒棘球蚴的感染,也在黑唇鼠兔、灰尾兔和灰仓鼠３种野生的中间宿主动物证实存在泡球蚴的感染。显示青海两种棘球绦     

原发性脾棘球蚴病1例报道

棘球蚴病由细粒棘球绦虫或多房棘球绦虫引起。人是其中间宿主。当误食虫卵后，六钩蚴经肠壁随血循环侵入组织，主要是肺和肝。孤立的原发性脾棘球蚴病很罕见。继发性的脾棘球蚴病主要是自发的或者手术引起的肝棘球蚴囊的破裂导致原头节向脾播散。这里介绍第一例用超声介导的细针诊断技术诊断的原发性脾棘球蚴病。     

甘南藏族自治州动物棘球绦虫感染状况调查

目的：了解甘南藏族自治州动物棘球绦虫及棘球蚴的感染状况,为该地区制定防制策略提供依据。方法：2004年8月耀2007年9月在甘南藏族自治州选择玛曲县和碌曲县的8乡21个自然村为调查点,采用鼠夹、粘鼠板捕捉啮齿类动物进行剖检,收集当地屠宰场绵羊、牦牛的肝、肺和心脏等剖检,进行棘球蚴病原学和病理学检查。对家犬、牧羊犬采用15%槟榔碱溶液驱虫,随机捕杀无主野犬剖检十二指肠成虫感染情况。结果：共捕获啮齿类动物331只,经剖检进行病理学检查和鉴定,4只感染多房棘球蚴,即达乌尔鼠兔（Ochotona daurica）和中华鼢鼠（Myospalax fontanieri）,感染率分别为1.2%（1/87）和2.3%（3/132）;6只喜马拉雅旱獭（Marmota himalayana）、34只西藏鼠兔（Ochotona tibetana）和72只小家鼠（Mus musculus）未感染棘球蚴。剖检绵羊1 021头,其中细粒棘球蚴和多房棘球蚴的感染率分别为11.1% （113/1 021）和0.3% （3/1 021）。剖检牦牛634头,其细粒棘球蚴和多房棘球蚴的感染率为19.9% （126/634）和0.3%（2/634）。犬的细粒棘球绦虫和多房棘球绦虫的感染率分别为23.0%（17/74）和5.4%（4/74）。牧羊犬、家犬棘球绦虫的检出率为24.6%（15/61）,无主野犬检出率为6/13,未发现两型绦虫的混合感染。结论：甘南藏族自治州动物以细粒棘球绦虫感染为主,有少量多房棘球绦虫感染。     

青海高原棘球绦虫不同宿主感染情况及意义的研究

目的 分析1990 - 2010年青海省青南高原、祁连山-河湟谷地、柴达木盆地三类地形区终末和中间宿主棘球绦虫或棘球蚴感染情况,为青海高原棘球蚴病防治工作提供参考依据.方法 采用寄生虫形态学方法鉴定终末宿主犬、狐狸和狼棘球绦虫感染情况;家养及野生中间宿主棘球蚴感染情况调查采用解剖学和病理学方法鉴定,并对部分可疑病灶采用分子生物学方法进行虫种鉴定.结果 青南高原、祁连山-河湟谷地、柴达木盆地三类地形区无主犬均存在细粒棘球绦虫感染,其感染率分别为38.71％( 300/775)、49.60％( 124/250)、9.76％(4/41),不同地形区间比较,差异有统计学意义(x2=25.72,P＜ 0.01),另外,仅有青南高原的无主犬存在多房棘球绦虫感染,感染率为16.04％(98/611);青南高原、祁连山-河湟谷地的狐狸多房棘球绦虫感染率分别为22.89％(38/166)、30.77％(12/39),且两地的狼存在细粒棘球绦虫感染.上述三类地形区家养绵羊、牦牛、山羊和猪棘球蚴感染率比较,差异有统计学意义(x2值分别为82.70、41.82、212.63、194.58,P均＜0.01);且三类地形区家养绵羊、牦牛棘球蚴感染率[43.43％(5664/13 042)、49.47％(2917/5896),52.99％(887/1674)、42.18％(779/1847),50.70％(1049/2069)、52.90％(685/1295)]均处于较高水平,青南高原家养山羊和猪棘球蚴感染率[3.26％(7/215)、0.00％(0/108)]明显低于祁连山-河湟谷地、柴达木盆地[19.51％(119/610)、26.91％(43/1598),47.91％(343/716)、21.91％(71/324)].上述三类地形区野生高原鼠兔棘球蚴感染率分别为6.21％(243/3910)、1.80％(3/167)、0.00％(0/199),三类地形区间比较,差异有统计学意义(x2=18.50,P＜0.01),仅在青南高原发现青海田鼠、灰尾兔、岩羊、藏原羚、黄羊棘球蚴感染.结论 青海高原三类地形区的人群感染细粒和多房棘球蚴病的压力来自不同终末宿主,而无主犬是造成人群棘球蚴病的关键传染源;各种终末宿主和家养、野生中间宿主之间具有复杂的生活史循环链,提示青海高原是我国棘球蚴病防控的重点地区,其防治任务十分艰巨.     

甘南藏族自治州终末宿主犬感染棘球绦虫状况调查

目的掌握甘南藏族自治州终末宿主犬细粒棘球绦虫和多房棘球绦虫感染状况,为该地区包虫病的传播动力学研究及开展大规模包虫病防治做好前期工作。方法选择碌曲县和玛曲县当地家犬、牧羊犬,采用15%槟榔碱溶液（21mg/kg体重）导泻后检查成虫,随机捕杀当地无主野犬,解剖十二指肠检查成虫。结果终末宿主犬细粒棘球绦虫感染率为22.97%（17/74）,多房棘球绦虫感染率5.41%（4/74）,合计感染率为28.38%,感染犬的感染度为43.29条/只。未发现两种绦虫混合感染。结论甘南藏族自治州犬细粒棘球绦虫感染率较高,并有多房棘球绦虫感染。     

棘球蚴分子生物学研究现状

能感染人类的棘球属绦虫有4种,即细粒棘球绦虫、多房棘球绦虫、少节棘球绦虫和福氏棘球绦虫.目前在我国仅发现2种,即细粒棘球绦虫(Echinococcus granulosus)和多房棘球绦虫(Echinococcus multilocularis).前者引起囊型棘球蚴病(cystic hydatid disease),亦即囊型包虫病(cystic echinococcosis),后者引起泡型棘球蚴病(alveolar hydatid disease),俗称泡型包虫病(alveolar echinococcosis).棘球属绦虫的终宿主为狗、猫、狐等食肉类动物,成虫寄生于小肠,人和其它中间宿主被终宿主粪便中的虫卵所感染.     

我国棘球绦虫感染的不同宿主状况

棘球绦虫感染是一种循环感染,棘球绦虫在食肉动物与食草动物之间形成较为固定的生活史循环链。食肉动物为终末宿主——以犬、狐、狼等犬科动物为主,棘球绦虫的中间宿主涉及不同物种并随环境的不同而有变化,主要有人、家畜和一些野生动物。棘球绦虫在完成其生活史过程中,能寄生几十种动物体内,尤其是其幼虫（棘球蚴）所寄生的中间宿主更为广泛。     

复杂性肝棘球蚴病外科治疗策略研究进展

肝棘球蚴病是一种由棘球属绦虫幼虫所致的人畜共患性疾病。我国主要致病绦虫类型为细粒棘球绦虫和多房棘球绦虫,分别引起细粒棘球蚴病和多房棘球蚴病。目前,棘球蚴病治疗已经取得重大进展,但对于部分就诊时已出现一种或多种并发症以及病灶侵及肝门、重要血管及胆管的复杂性棘球蚴病病例的治疗仍存在一定困难。本文根据近年来文献报道,结合临床经验,对复杂性肝棘球蚴病的外科治疗策略进行综述。［关键词］     

回顾棘球绦虫及棘球蚴病的研究现状—着重报道我国的贡献成果

目的 回顾棘球绦虫及其棘球蚴病的当代研究成果,着重论述我国对本虫病原学和流行学的研究贡献。方法 评阅有关本虫病的研究资料,分析、讨论、总结病原虫种、终期和中间宿主动物,病原与宿主之间相互关系及其流行、传播规律。结论 当代全球有7种棘球绦虫,我国有5种,其中石渠棘球绦虫是青藏高原特有的新虫种。全球有20多种食肉兽类作为终期宿主,我国已知自然感染有5种,其中藏狐为宿主新记录。细粒棘球绦虫的中间宿主除大型家畜（牛、马、羊、猪）外,尚有多种鹿类有蹄动物和人体等。多房性棘球绦虫的中间宿主有9科26属46种啮齿类动物,我国已报道有6科10属14种啮齿动物为自然宿主,人体也会感染。此外绵羊、牦牛、猪等家畜虽报道有自然感染多房蚴,但病理学显示病肝组织纤维化,泡囊均无原头节,与人体感染的肝病变相似,拟是不正常的中间宿主或是多囊性的细粒棘球蚴感染。     

新疆北部多房棘球绦虫动物宿主研究初报

本文报告在新疆北部泡型包虫病流行地区的农村牧区以及山地和草原地带进行多房棘球绦虫终宿主和中间宿主调查的结果。采用槟榔碱导泻法检查 30 5只家 (牧 )犬 ,在 5 2只犬中检出棘球绦虫成虫 ,感染率为 17%。对所获 13974条虫体进行鉴定的结果 ,皆为细粒棘球绦虫。表明在新疆北部泡型包虫病流行地区 ,家犬不是多房棘球绦虫的终宿主。检查啮齿目动物 31种 5 16 3只 ,食虫目动物 4种 2 6 1只和兔形目动物 2种 196只。在西部天山地区捕获的伊犁田鼠和塔尔巴哈台山地区捕获的水鼠平中发现多房棘球蚴感染 ,表明这两种鼠类是当地多房棘球绦虫的中间宿主。属于国内新记录。     

Past to present: echinococcosis in Turkey

Echinococcosis is a zoonotic infection caused by Echinococcus spp. and is one of the most important helminthic diseases worldwide. Two forms of echinococcosis occur in Turkey, i.e. Echinococcus granulosus and E. multilocularis. The life cycle of E. granulosus is predominantly in dogs and sheep, and most sheep farmers in Turkey keep a dog or two. Stray dogs are numerous and prevention or treatment of infection in these dogs is very difficult. Cystic echinococcosis (CE) occurs throughout Turkey whereas alveolar echinococcosis (AE) predominantly occurs in the eastern Anatolian region of the country. Both CE and AE are known to be endemic but few surveys have been performed. Most data on human CE and AE have been collected from hospital records. The first reference of echinococcosis, "Kyste hydatique multiloculaire", in Turkey dates as far back to 1872 by an Ottoman Physician, C.R. Katibian. The results of the first Turkish study on E. granulosus were published in 1928. According to Ministry of Health records, 21303 patients had operations to treat or confirm CE in the period 1987-1994 which corresponds to approximately 2663 patients per year. The estimated surgical case rate of CE is 0.87-6.6 per 100000 in Turkey. The prevalence of E. granulosus infection in dogs in Turkey is between 0.32 and 40% and varies widely with geographical location. The reported prevalence of CE in domestic animals in Turkey has ranged from 11.2 to 50.7% and has varied widely with geographical location. Although no detailed information has been published on AE in domestic and wild animals in Turkey, the main definitive and intermediate hosts of E. multilocularis are assumed to be rodents and red foxes, respectively. However, there has been only a single published report of E. multilocularis in a wild animal (fox) in the northwest in 1965 by Merdivenci. The first human case of AE in Turkey was reported by Mutlu in 1939, and total cumulative reported case number is 202 between 1980 and 1998.     

青海省动物棘球蚴病及棘球绦虫感染的流行病学调查

【提要】 采用解剖学方法和寄生虫学方法进行了棘球绦虫中间宿主和终末宿主调查，了解青海省动物棘球蚴病/棘球绦虫感染的流行现状。结果表明，青海省家畜棘球蚴病的流行有升高的趋势，主要畜种绵羊和牦牛的平均感染率达50%以上。野生中间宿主动物感染率以青南高原为最高，祁连山地域的犬、狼等终末宿主动物的感染率高于其他两个地形区。青海省棘球绦虫的生活史循环链复杂，动物感染率高，对人类健康构成威胁，应因地制宜地采取有效措施，加强动物棘球蚴病和棘球绦虫病的防治。     

Dual infection of animal hosts with different Echinococcus species in the eastern Qinghai-Tibet plateau region of China

The eastern Qinghai-Tibet plateau of China is a highly endemic region of echinococcosis where Echinococcus granulosus sensu stricto (sheep strain), Echinococcus multilocularis, and Echinococcus shiquicus are distributed sympatrically. We developed a polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) method for the identification of the three species in this region. The PCR-RFLP showed the dual infection of animals with different Echinococcus spp. The first case was a domestic dog concurrently infected with adults of E. granulosus and E. multilocularis. The second case was a plateau pika (Ochotona curzoniae) harboring metacestodes of E. multilocularis and E. shiquicus in the liver. The high susceptibility of some mammalian hosts to the parasites and the high prevalence of the three co-endemic species probably increase the chance of mixed infections in the eastern Tibetan plateau.     

青藏高原地区犬棘球绦虫感染的流行病学特征

青藏高原地区是世界上已知的两型棘球蚴病的高流行区,但其犬细粒棘球绦虫的感染率却与世界其他高流行区无明显区别,大部分地区的感染率低于40%。调查资料显示,与其他流行区犬多房棘球绦虫感染呈零星的点状分布特征不同,位于青藏高原的四川省甘孜州和青海省的犬多房棘球感染普遍存在,且感染率较高。甘孜州的犬棘球绦虫总感染率在1983-2009年基本保持稳定,青海省的棘球绦虫属总感染率2000-2014年间变化也不大。2006年以来,我国棘球蚴病流行区启动了一系列综合防治措施,取得了一定成效。2009-2013年,四川省棘球蚴病流行区犬棘球绦虫感染率分别为28.10%、15.87%、19.22%、3.28%和1.11%,甘肃省甘南州、青海省部分区域的犬棘球绦虫感染率也出现了下降。本文对青藏高原地区的犬棘球蚴感染规律和特征进行了文献回顾与分析,以期为棘球蚴病的防控提供可借鉴的信息。     

Current status of diagnosis and treatment of hepatic echinococcosis

Echinococcus granulosus(E.granulosus) and Echinococcus multilocularis(E.multilocularis) infections are the most common parasitic diseases that affect the liver.The disease course is typically slow and the patients tend to remain asymptomatic for many years.Often the diagnosis is incidental.Right upper quadrant abdominal pain,hepatitis,cholangitis,and anaphylaxis due to dissemination of the cyst are the main presenting symptoms.Ultrasonography is important in diagnosis.The World Health Organization classification,based on ultrasonographic findings,is used for staging of the disease and treatment selection.In addition to the imaging methods,immunological investigations are used to support the diagnosis.The available treatment options for E.granulosus infection include open surgery,percutaneous interventions,and pharmacotherapy.Aggressive surgery is the first-choice treatment for E.multilocularis infection,while pharmacotherapy is used as an adjunct to surgery.Due to a paucity of clinical studies,empirical evidence on the treatment of E.granulosus and E.multilocularis infections is largely lacking;there are no prominent and widely accepted clinical algorithms yet.In this article,we review the diagnosis and treatment of E.granulosus and E.multilocularis infections in the light of recent evidence.     

Echinococcosis

Echinococcosis is a near-cosmopolitan zoonosis caused by adult or larval stages of cestodes belonging to the genus Echinococcus (family Taeniidae). The two major species of medical and public health importance are Echinococcus granulosus and Echinococcus multilocularis, which cause cystic echinococcosis and alveolar echinococcosis, respectively. Both are serious and severe diseases, the latter especially so, with high fatality rates and poor prognosis if managed incorrectly. Several reports have shown that both diseases are of increasing public health concern and that both can be regarded as emerging or re-emerging diseases. In this review we discuss aspects of the biology, life cycle, aetiology, distribution, and transmission of the Echinococcus organisms, and the epidemiology, clinical features, treatment, and diagnosis of the diseases they cause. We also discuss the countermeasures available for the control and prevention of these diseases. E granulosus still has a wide geographical distribution, although effective control against cystic echinococcosis has been achieved in some regions. E multilocularis and alveolar echinococcosis are more problematic, since the primary transmission cycle is almost always sylvatic so that efficient and cost-effective methods for control are unavailable.     

Augmented bioavailability and cysticidal activity of albendazole reformulated in soybean emulsion in mice infected with Echinococcus granulosus or Echinococcus multilocularis

The anthelminthic drug, albendazole (Abz), was reformulated in a soybean oil emulsion and evaluated as a therapeutic agent for the treatment of Echinococcus granulosus and Echinococcus multilocularis in mice. Abz emulsified with 30% soybean oil (AbzE-30) resulted in higher circulating plasma concentrations of the major bioactive Abz metabolite, Abz sulfoxide (AbzSOX), after oral administration, compared with an Abz suspension. The soybean oil-emulsified Abz compound was also noted to penetrate into the hydatid cyst wall and produced higher hydatid cyst concentrations of AbzSOX. The emulsion was superior to Abz suspension in reducing the size of hydatid cysts caused by E. granulosus protoscolices collected from naturally infected sheep in Urumchi, Xinjiang Uygar Autonomous Region. In contrast, the reformulated compound's ability to reduce E. multilocularis cyst masses was only marginally superior to Abz suspension. AbzE-30 exhibited increased bioavailability and bioactivity in the treatment of murine Echinococcus hydatid cyst infections. The compound has the potential for improving therapeutic outcomes for human echinococcosis.     

Molecular confirmation of human alveolar echinococcosis in Poland

Infections of humans with Echinococcus multilocularis, the causative agent of alveolar echinococcosis (AE), a zoonosis, have been described with increasing frequency in Poland since 1994. In the attempt to verify these reports, we analyzed specimens obtained from a representative group of Polish patients. Liver lesions in patients with AE that was diagnosed on the basis of results of histological and serological tests contained E. multilocularis DNA, as shown by the presence of specific microsatellite sequences and mitochondrial 12S rDNA. The same tests clearly distinguished between AE and cystic echinococcosis, which is caused by Echinococcus granulosus. These data are unequivocal proof that human infections with E. multilocularis occur in Poland.