以头痛为主要症状的囊尾蚴病8例临床分析

目的：通过研究囊尾蚴病的流行病学和临床特征,加强临床工作者对囊尾蚴病的认识,提高临床诊治水平。方法：回顾性分析2009年1月—2015年12月于南京医科大学第一附属医院住院治疗的8例以头痛为主要症状并确诊为囊尾蚴病患者的流行病学资料、临床表现、辅助检查结果、诊断、治疗与转归等。结果：8例囊虫病患者中,男5例、女3例,年龄23～54岁,平均年龄40岁;汉族7例,侗族1例;3例有喜食生肉、涮火锅等爱好,其余5例无明确流行病学史。临床表现方面,7例为脑囊尾蚴病,1例为混合型囊尾蚴病（脑型合并皮下及肌肉型）;5例以头痛伴或不伴恶心、呕吐为首发症状,2例以头痛伴癫痫为首发症状,1例以头痛伴上肢不利为首发症状。3例患者白细胞轻度升高,2例轻度贫血,嗜酸性粒细胞计数均在正常范围内。5例患者行脑脊液检查,3例蛋白含量升高,2例细胞数轻至中度升高,且以淋巴细胞增多为主。7例患者行血清囊尾蚴特异性抗体检测,有4例阳性。5例患者行头颅CT,仅1例影像学初步诊断时考虑脑囊虫病可能;8例患者均行头颅MRI,有4例影像学初步诊断时考虑寄生虫或囊虫病可能。3例患者予以吡喹酮,1例予以口服吡喹酮及槟榔南瓜子,2例予以阿苯达唑抗虫治疗,2例行脑室—腹腔分流术并予以吡喹酮抗虫治疗。结论：非流行区医务工作者对于无法用常见病解释的头痛、癫痫患者应警惕囊尾蚴病可能。     

Cysticercosis cerebri. Report on seven cases

Summary The authors report the clinical features, diagnosis and treatment of seven personal cases of cerebral cysticercosis. The epidemiology, anatomical location and therapeutic possibilities are studied. A brief review of the literature of 814 cases of neurocysticercosis is also reported.     

Evaluation of “crude” antigen prepared fromTaenia saginata for the serological diagnosis ofT. saginata cysticercosis in cattle using the enzyme-linked immunosorbent assay (ELISA)

A crude antigen prepared from the strobilate stage ofTaenia saginata was tested for its suitability in the peroxidase microenzyme-linked immunosorbent assay (ELISA) for the diagnosis ofT. saginata cysticercosis in cattle. Sera were tested from laboratory and pasture-reared calves experimentally infected withT. saginata as well as from cattle naturally infected by grazing on pasture irrigated with sewage effluent. The specificity of the diagnostic antigen was assessed using sera from laboratory-reared cattle with monospecific infections ofT. saginata, T. hydatigena, Fasciola hepatica, or gastro-intestinal nematodes, and natural infections ofF. hepatica. Cross-reactions occurred in sera from all heterologous infections but the highest level occurred in cattle experimentally or naturally infected withF. hepatica. Clear diagnostic antibody levels were found in cattle experimentally infected withT. saginata but the test was not found to be reliable in individual animals with natural infections when compared with sera from cattle naturally infected withF. hepatica. On a group or herd basis ELISA using crude antigen and taking the mean absorbance values, could be useful as an indicator of a high prevalence rate ofT. saginata cysticercosis.     

CEREBRAL CYSTICERCOSIS: A CASE REPORT WITH PARTICULAR REFERENCE TO RECENT ADVANCES IN DIAGNOSIS AND TREATMENT

Cerebral cysticercosis is becoming more common in Australia as the immigrant population from areas of endemic disease increases. The case reported exemplifies the common presentation of this interesting infestation.
Treatment consists primarily of Praziquantel with or without steroids and anti-seizure medication if indicated. Follow-up is by both clinical and radiological assessment.     

Spinal cysticercosis

A case with cysticercosis cysts in the spinal subarachnoid space with unique myelographic features is discussed. One of the cysts moved within the spinal subarachnoid space during the myelographic examination. Recognition of the possibility that mobility of the cyst may occur between the time of the myelographic study and laminectomy is important for the surgeon.     

用酶联免疫吸附试验（微量间接法）诊断人体囊尾蚴病

人囊尾蚴病是一种严重危害人类健康的人畜共患寄生虫病，其免疫诊断法很多。本文采用ＥＬＩＳＡ微量间接法，对１９９例囊虫病人、正常人和其他患者作了检测。囊虫病人１３６例中，检测阳性１２６人，阳性率为９２．６％。实验表明，本法敏感性与特异性强，重复性良好，是值得推广应用的囊虫免疫诊断方法之一。     

不同组合快速双抗体夹心ELISA检测囊虫循环抗原的研究

用抗猪囊虫单克隆抗体和其特异性多克隆抗体的４种组合进行快速及抗体夹心ＥＬＩＳＡ检测囊虫病人血清中的循环抗原。结果表明，双单抗法的检出率最高（６７．５％），其余依次为多抗－单抗法（５４．１７％）、单抗－多抗法（５０．８３％）和双多抗法（４９．１７％）。它们与包虫、弓形虫病人的交叉反应及正常人的假阳性反应无显著差异（Ｐ〉０．０５），但与肝吸虫病人的交叉反应有极显著的差异（Ｐ〈０．０１），以双单抗法最低     

猪囊尾蚴细胞疫苗对仔猪先天性和获得性免疫的作用

目的观察猪囊尾蚴细胞疫苗对妊娠母猪、具有母源抗体的仔猪和正常仔猪的影响.方法通过ELISA方法检测血清抗体,以确定疫苗对不同实验猪的免疫效果.结果妊娠母猪产生的抗体可达到1：20480,并使仔猪获得的母源抗体接近有效抗体滴度1：2560,出生后适时追加免疫,短期内即可产生较高抗体水平.结论 猪囊尾蚴细胞疫苗免疫怀孕母猪后,母猪体内产生的抗体可以传递给仔猪,使仔猪获得先天性免疫力,具备抵抗猪囊尾蚴虫卵的侵袭.免疫正常仔猪产生有效抗体时间较晚.     

灭囊灵对体外猪囊尾蚴作用的电镜观察

目的：观察灭囊灵在体外对猪囊尾蚴的治疗作用，方法：用扫描电镜和透射电镜观察灭囊灵醇提物、吡喹酮和现硫咪唑体外作用于猪囊尾蚴后的病变。结果扫描电镜下见灭囊灵和吡喹酮组头节均未翻出，囊壁萎缩，皮层外质膜受损，微毛细胞不清或脱落，表面布满颗粒状物；丙硫咪唑组４６．７％已脱囊，顶突头钩发育正常，４个吸血表面凹陷，颈部糜烂，体节正常沟条消失。透射电镜下见灭囊灵和吡喹酮组虫体皮层、基底膜、肌层和实质层均明显受     

Brain cysticercosis treated with Praziquantel. Report of six cases

Summary Cysticercosis is the most common parasitosis affecting the central nervous system and it is endemic in many countries.Although cysticercosis is nowadays a rare disease in Spain, three of such cases have been treated with Praziquantel at the Hospital Princesa Sofia of León and another three at the Hospital General de Galicia of Santiago, and the six of them are reported together.The six patients presented at CT scans cysts located at different levels in the brain parenchyma, subarachnoid space and ventricular system. Praziquantel was administrated at daily dosage of 50 mg per kilogram of body weight, by oral route, distributed in three doses during 15 days. Moderate hepatotoxic effect were detected in two cases. No significant neurological disfunction was observed in any case during the treatment. The therapeutic effect on the brain cysts was evaluated in the CT scans obtained after treatment. In four cases a positive effect on the cysts was observed, but no apparent effect was noticed in the other two.