脑囊虫病的CT诊断(附110例分析)

分析了110例各型脑囊虫病的CT表现、各型CT表现的病理基础,提出将CT表现结合囊虫发育的病理演变过程进行分期,以利动态观察与治疗。认为单个不典型病灶易误诊,应特别注意,并观察了24例经口服吡喹酮治疗半年后的疗效。     

Efficacy of ivermectin and oxfendazole against Taenia solium cysticercosis and other parasitoses in naturally infected pigs

Smallholder semi-confined pig production is a fast growing practice in sub-Saharan Africa with an unfortunate outcome of high prevalence of Taenia solium cysticercosis and other parasitoses. The widely used anthelmintic for control of endo and ecto-parasites in pigs in the area is ivermectin at a recommended dose of 0.3 mg/kg. This study was conducted to evaluate the efficacy and safety in pigs after subcutaneous injection of ivermectin (IVM, 0.3 mg/kg) and orally administration of oxfendazole (OFZ, 30 mg/kg) in treatment of porcine cysticercosis and other parasitoses in naturally infected pigs. A total of 61 pigs with T. solium cysticercosis (38 males and 23 females) as identified by tongue palpation with age ranging from 3 to 24 months were recruited. The pigs were stratified based on sex, age and number of cysts on the tongue and randomly allocated to IVM, OFZ and control groups. Three days before treatment and two weeks after treatment faecal samples and skin scrapings were taken to establish the burden of endo- and ectoparasites, respectively and the effect of the treatment. No adverse effect was observed in any of the treatment groups throughout the study period. Half of the pigs from each group were slaughtered at week four and the remaining half at week twelve post treatment. The IVM treatment group had no significant effect (p = 0.224) on T. solium cysts viability in comparison to the control group. Significant effect on cysts viability was observed in the OFZ treated group (p < 0.001) compared to IVM and control groups in all muscle tissues. Regarding to brain cysts, neither of the drugs was efficacious. Ivermectin and OFZ treatments significantly reduced (p < 0.001) the faecal egg count of Ascaris suum, strongyles and Trichuris suis two weeks after treatment. At slaughter, Oesophagostomum dentatum, Ascarops strongylina and Physocephalus sexalatus were recovered from pigs in the IVM treated and in the control groups. Ivermectin was 100% effective in control of Sarcoptes scabiei. In conclusion, IVM at a single dose of 0.3 mg/kg was efficacious against ectoparasites but did not effectively cure pigs from T. solium cysticercosis or nematodes. Oxfendazole, on the other hand, killed all nematodes and muscle cysts, but did not have any effect on ectoparasites. A combination of the two drugs would be a most useful treatment option for control of pig parasitoses in sub-Saharan Africa.     

一例视网膜猪囊尾蚴病患者的护理

正视网膜猪囊尾蚴病是一种寄生虫引起的疾病,是人误食猪肉绦虫虫卵或孕节后,在小肠内发育为猪囊尾蚴,并寄生在人体的眼内引起的人畜共患寄生虫病。眼内猪囊尾蚴多数寄生在玻璃体和视网膜~[1],寄生在视网膜的称之为视网膜囊尾蚴病或视网膜猪囊尾蚴病。云南省大理地区少数民族:白族,因喜食生猪皮而成为该病多发地区。猪囊尾蚴进人眼内后,囊液中的毒素及异种蛋白质经囊壁释放,在眼内引起局部组织肉芽肿性炎症反应,伴纤维增生,早期视网膜     

不同抗囊尾蚴抗体检测试剂盒用于囊尾蚴病血清学诊断效果评价

目的　评价不同厂家生产的4种抗囊尾蚴IgG、IgG4和IgM抗体酶联免疫吸附试验（ELISA）检测试剂盒的诊断效果,为囊尾蚴病流行病学调查和临床检测提供参考。方法　采用A品牌3种抗囊尾蚴抗体（IgG、IgG4和IgM抗体）ELISA检测试剂盒以及B品牌抗囊尾蚴IgG抗体ELISA检测试剂盒,同时检测40份脑囊尾蚴病患者、100份健康人、30份斯氏并殖吸虫病患者、17份细粒棘球蚴病患者和19份皮下或脑裂头蚴病患者血清,比较不同试剂盒检测囊尾蚴病的敏感度、特异度和假阳性率。结果　A品牌抗囊尾蚴IgG、IgG4和IgM抗体ELISA试剂盒以及B品牌抗囊尾蚴IgG抗体ELISA试剂盒检测囊尾蚴病的敏感度分别为95.00%（38/40）、87.50%（35/40）、7.50%（3/40）和75.00%（30/40）,特异度分别为98.00%（98/100）、100.00%（100/100）、100.00%（100/100）和100.00%（100/100）;A品牌抗囊尾蚴IgG抗体ELISA试剂盒检测囊尾蚴病的敏感度高于B品牌（[χ2] = 6.28,P < 0.05）,两者特异度差异无统计学意义（[χ2] = 2.01,P > 0.05）。4种试剂盒检测并殖吸虫病、细粒棘球蚴病、裂头蚴病患者血清总假阳性率分别为37.88%（25/66）、22.73%（15/66）、62.12%（41/66）和15.15%（10/66）（[χ2] = 37.61,P < 0.05）;其中A品牌抗囊尾蚴IgM抗体ELISA试剂盒检测总假阳性率最高（[χ2] = 7.56,P' < 0.008）,A品牌抗囊尾蚴IgG抗体ELISA试剂盒检测总假阳性率高于B品牌（[χ2] = 8.75,P' < 0.008）。4种试剂盒检测并殖吸虫病患者血清假阳性率分别为40.00%（12/30）、16.67%（5/30）、76.67%（23/30）和13.33%（4/30）（[χ2] = 32.88,P < 0.05）,检测裂头蚴病患者血清假阳性率分别为21.05%（4/19）、26.32%（5/19）、73.68%（14/19）和15.79%（3/19）（[χ2] = 19.97,P < 0.05）,均以A品牌抗囊尾蚴IgM抗体ELISA试剂盒检测假阳性率最高（P' 均 < 0.008）。4种试剂盒检测细粒棘球蚴病患者血清假阳性率分别为52.94% （9/17）、29.41%（5/17）、23.53%（4/17）和17.65%（3/17）,差异无统计学意义（[χ2] = 8.24,P > 0.05）。A品牌抗囊尾蚴IgM抗体ELISA试剂盒检测并殖吸虫病、棘球蚴病和裂头蚴病患者血清假阳性率分别为76.67%（23/30）、23.53%（4/17）和73.68%（14/19）（[χ2] = 14.537,P < 0.05）,其中检测棘球蚴病患者血清假阳性率最低（[χ2] = 14.537,P' < 0.014）;其他3种试剂盒检测并殖吸虫病、棘球蚴病和裂头蚴病患者血清假阳性率差异均无统计学意义（P 均> 0.05）。 结论　不同囊尾蚴病免疫学诊断试剂各有优劣;A品牌抗囊尾蚴IgG抗体ELISA试剂盒敏感度较高,但需进一步解决与其他寄生虫病的交叉反应和稳定性问题。     

168例猪囊虫病心理障碍患者的临床资料分析

目的了解有心理障碍的猪囊虫病患者分布和发病特点及治疗情况,为防治提供依据。方法从2005-2006年经山东省寄生虫病防治研究所确诊的猪囊虫病住院患者中,挑选168例有心理障碍的病例进行调查和统计分析。结果168例患者中,山东籍150例（89.29%）,分布于全省16个地级市。农村患者与城镇患者之比为2.45∶1;男女患者之比为2.43∶1;年龄以18-45岁的中青年患者所占比例最高,为64.80%;临床分型以脑囊虫病所占比例最高,为76.79%。所有患者共分4种心理类型,其中消极悲观型占36.31%,忧郁自卑型占31.55%,焦虑恐惧型占24.40%,对抗偏执型占7.74%。用吡喹酮（PQT）结合阿苯哒唑（ALB）治疗后,总有效率为98.21%,治愈率为45.24%。结论山东省猪囊虫病仍处于较高的发病态势,患者以农村男性中青年占多数;吡喹酮（PQT）和阿苯哒唑（ALB）联合应用仍是目前猪囊虫病的有效治疗方法。     

膝关节包囊虫病1例

患者男,46岁,兽医,因右膝关节酸痛来医院就诊.查体:右膝关节饱满,未见明显红肿.生化检查:Casoni试验及包囊虫补体结合试验均阳性.X线检查:双膝关节未见明显异常.彩超检查:于右膝关节髌上囊内探及数十个大小不等的圆形和椭圆形囊性无回声,最大的囊腔大小约15 mm×13 mm,最小的约2 mm×2 mm,囊内可见小囊,并可探及分隔;囊内透声清亮,囊壁薄,厚薄均匀、光滑、完整,连续性好,髌上囊后方的股骨下端骨膜完整,回声均匀(图1、2).肝脏内未探及明显异常回声.     

Lingual Cysticercosis: A Case Series with Review of Literature

Cysticercosis is a condition in which humans are infected by the larval form of Pork Tapeworm Taenia solium. Isolated lingual cysticercosis is a rare entity due to the high muscular activity and metabolic rate of tongue which prevents the development of larva. We present a series of three patients with isolated lingual cysticercosis. One patient was treated by medical management while the other two were treated with surgical excision followed by medical therapy. All patients are asymptomatic after repeated follow ups.     

脑室内猪囊虫病的CT和MR影像学诊断

报告经手术和病理证实的脑室内猪囊虫病３７例。ＣＴ轴位扫描均表现为脑室不对称性扩大，以囊虫所在的脑室扩大最为明显；增强扫描４例均无强化病灶；Ｉｓｏｖｉｓｔ脑室造影ＣＴ扫描２８例，２７例见脑室内球形低密度充盈缺损，１例导水管以上无占位性病变，导水管以下无造影剂。２例改变体位后复查ＣＴ扫描，充盈缺损病灶位置有改变。３例ＭＲ均表现为第四脑室扩大特别显著，第三脑室和双侧侧脑室扩大。对脑室内猪囊虫病的ＣＴ和ＭＲ影像学特点进行了讨论。