摘要
目的 调查洞庭湖渔民感染血吸虫的严重程度 ,评估其化疗防治效果。 方法 2 0 0 1年 11月选择湖南省岳阳县麓角镇洞庭湖水上作业渔民 ,询问血吸虫感染与化疗史。用改良加藤法检查虫卵和毛蚴孵化法检查毛蚴 ,酶联免疫吸附测定 (ELISA)和间接血凝试验 (IHA)检测抗可溶性虫卵抗原 (SjSEA )的抗体 ,B超检查肝 /脾病变程度。人群顿服吡喹酮 40mg/kg ,一个感染季节过后复查。用SPSS软件进行分析。 结果 ①询问调查渔民 2 68人 ,“经常”或“间常”接触疫水的人数占 90 7% ;近 5年每年平均化疗人数占 2 4 0 % ,从未化疗者占 3 9 4% ;②粪检阳性率为 68 1% (111/163 ) ,克粪虫卵数 (EPG )为 48 77,男性均显著高于女性。 11～ 2 0岁阳性率最高(83 3 % ) ,“经常”或“间常”接触疫水与从未化疗的两种人群阳性率分别为 76 3 % (10 6/13 9)和 79 7% (5 1/64 ) ;③IHA检测阳性率为 88 0 % ,ELISA检测阳性率为 78 7% ,均明显高于粪检阳性率 ;④肝 /脾受损率为 77 4% (82 /10 6) ,其中 ,肝实质呈Ⅱ～Ⅲ级纤维化病变者占 3 7 7% ,肝肿率为 5 8 5 % ,脾肿率为 19 8% ;⑤多次化疗人群感染率和EPG显著低于从未化疗人群 ;⑥复查结果表明 ,化疗人群粪检阳性率 (3 5 4% )和EPG (3 6 13 )较未化疗人群(5 6 5 %和 68
Objective To clarify and evaluate the morbidity of schistosome infection and the effectiveness of chemotherapy among fishermen on East Dongting Lake. Methods Information on water\|contact, history of infection and of praziquantel(PZQ) treatment among fishermen was collected. Kato\|Katz method and miracidium hatching test were applied to detect the pathogens in stool specimen. Serum antibodies against soluble egg antigen (SEA) were detected with ELISA and IHA. B\|ultrasonic examination was used to determine the pathological changes of liver and spleen. Chemotherapy[PZQ 40 mg/(kg·d)] was given to the fishermen followed by a re\|examination after a transmission season. Results The first investigation (six months before chemotherapy) showed that among 268 people inquired, 90\^7% were frequently or intermittently contacting water, 24\^0% were treated with PZQ each year, 39\^4% had never been treated in the recent five years. Stool positive rate was 68\^1% (111/163) and the geometric mean eggs per gram feces (EPG) were 48\^77. Males had a higher infection rate (76\^0%) and intensity (62\^97 EPG) compared with that of females (58\^7% infection rate and 30\^42 EPG). The highest positive rate (83\^3%) was in the age group of 11 to 20 years old. The prevalence of those who frequently or intermittently contacted water and were never treated before was 76\^3% (106/139) and 79\^7% (51/64), respectively. Serological positive rate was 88\^0% (IHA) or 78\^7% (ELISA). B\|ultrasound revealed 77\^4% (82/106) of the fishermen showing pathological changes in liver and/or spleen due to schistosomiasis. 37\^7% of the patients showed Ⅱ-Ⅲ stage liver fibrosis (male: 53\^0%, female: 15%), 58\^5% hepatomegaly and 19\^8% splenomegaly. The second investigation (six months after chemotherapy with PZQ) showed a stool positive rate of 35\^4% and an average EPG 36\^13 in the treatment group which were considerably lower than 56\^5% infection rate and 68\^47 EPG in the group without treatment. In 39 patients treated, the rev
出处
《中国寄生虫学与寄生虫病杂志》
CAS
CSCD
北大核心
2004年第4期199-203,共5页
Chinese Journal of Parasitology and Parasitic Diseases
基金
湖南省世行贷款和血吸虫病专家咨询委员会资助 (2 0 0 0 2 0 0 2 )~~
