绦虫幼虫所致疾病的诊断

由于绦虫幼虫是高致病性病原,诊断绦虫幼虫感染就显得很重要.本文对目前应用的诊断方法病原学诊断,影像学诊断,免疫学诊断和分子生物学诊断技术进行详细的阐述.病原学诊断只是在囊性棘球蚴病和部分活动性脑囊尾蚴病的诊断中得到有效的和有限的应用.X线,CT和核磁共振(MRI)用于脑囊尾蚴病诊断.影像学诊断用来确诊囊性棘球蚴病和泡型棘球蚴病.X线是最便宜的诊断肺部囊性棘球蚴病和泡型棘球蚴病的方法.超声波检查作为诊断囊性棘球蚴病腹部包囊的首选诊断方法.MRI是最贵的影像学诊断方法,但仅仅用于诊断颅内囊性棘球蚴病和泡型棘球蚴病.在大多数发展中国家,IgG-ELISA是诊断人类囊性棘球蚴病和泡型棘球蚴病的一种好方法.虽然诊断特异性血清抗体可以获得高敏感度,但仍有部分病人的抗体不能检测出.幼虫囊包的位置、完整性和活性决定了抗体的检测效果.分子生物学技术是敏感度和特异度最高的诊断方法,但是,也是最昂贵的诊断方法.现在首选的诊断绦虫幼虫所致疾病的方法是综合影像学和免疫学方法.

The diagnosis of diseases due to cestode infection

As the larval cestodes is highly pathogenic to human,it is important for diagnosis of larval cestode infections.This review presented diagnosis methods used: parasitological diagnosis,imaging techniques,immunological diagnosis,and molecular biological techniques.Parasitological diagnosis is limitedly used in cystic echinococcosis(CE) and part of active neurocysticercosis patients.X-ray,Computed tomography(CT) and magnetic resonace imaging(MRI) are useful in neurocysticercosis.Definitive diagnosis of CE and alveolar echinococcosis(AE) can be achieved by various imaging technique.X-ray is cheaper than others used for pulmonary of AE and CE,ultrasonography(US) for abdominal cyst in CE as primary diagnosis technique and MRI,the most expensive imaging technique,only for cerebral AE and CE.In most developing counties,IgG-ELISA is one of the best choices for diagnosis of human cystic echinococcosis and alveolar echinococcosis.Even highly sensitive test can be achieved by detecting specific serum antibodies,there are antibodies of a certain proportion of patients can not be detected.The detectable antibodies depend on the physical location,integrity and vitality of the larval cysts.Molecular biological techniques are the most sensitive and specific diagnosis techniques,but the cost of applyication is much more than other diagnostic methods.The primary methods for diagnosis of larval cestodes infection are combination of imaging technique and immunological diagnosis.