摘要
目的探讨并殖吸虫病的流行病学特征、临床表现、实验室检查、诊断、治疗与预后的特点,提供完善的资料供临床参考。方法收集和分析2011-2019年云南省收治的12例并殖吸虫病患者临床资料。结果患者来自云南省7个地市,人群特征以男性、汉族及学生为主;流行病学史明确日临床表现多样;血常规检验嗜酸性粒细胞及血小板增高、像学检查可发现受损组织器官的改变、并殖吸虫抗体ELISA检查阳性率为100%。病理检查获斯氏狸殖吸虫幼虫2例;临床分型为胸肺型2例,肺外型6例,混合型4例;10例病例有肺外感染,其中皮下包块5例、腹腔4例、肝脏3例、心包2例、脑1例。患者确诊前往往长期误诊误治,予吡喹酮和阿苯达唑联合治疗1~4疗程后均痊愈。结论并殖吸虫能侵犯人体不同组织器官,临床表现缺乏特异性,常误诊误治;血常规检验嗜酸性粒细胞及血小板增高应高度怀疑并殖吸虫感染,并殖吸虫抗体ELISA检查阳性率高,发现病原体可确诊;流行病学对诊断有重要意义;吡喹酮和阿苯达唑联合治疗效果较好。
Objective To explore epidemiological characteristics, clinical manifestations, laboratory examination, diagnosis, treatment and prognosis of paragonimiasis so as to provide information for diagnosis and treatment. Methods Clinical data of 12 cases of paragonimiasis patients from 2011 to 2019 were collected and analyzed. Results The patients came from seven different areas in Yunnan Province. Most cases were males,Han nationality and students. All patients had clear epidemiological histories. The clinical manifestations are diverse. Routine blood tests showed that eosinophils and platelets increased. Damaged tissues and organs could be found by imaging examination. The positive rate of antibody against Paragonimus was 100% by using ELISA. Pathological examination found that two patients had larvae of Pagumogonimus skrjabini. Two cases were thoracopulmonary type of paragonimiasis,six cases were extrapulmonary type of paragonimiasis,and four cases were mixed type of paragonimiasis. 10 cases had extrapulmonary infection. 5 cases had subcutaneous mass. 4 cases had masses in abdominal cavity, 3 cases in liver, 2 cases in pericardium, and 1 case had masses in brain. All patients were misdiagnosed and mistreated for a long time.After the treatment with combination of praziquantel and albendazole for 1 to 4 courses, all patients recovered. Conclusion Paragonimus spp can invade different tissues and organs of human body. Paragonimiasis lack of specificity in clinical manifestations,often leading to misdiagnosis and mistreatment. If the routine blood tests show that eosinophils and platelets elevated, paragonimus spp infection should be highly suspected. The positive rate of ELISA is high. The patients can be diagnosed if found pathogen. Epidemiological characteristics are important for diagnosis. The combination of Praziquantel and Albendazole has good therapeutic effects.
作者
杨琼
YANG Qiong(Dali Institute of Research and Control Schistosomiasis in Dali Prefecture,Dali 671000,Yunnan Province,China)
出处
《寄生虫病与感染性疾病》
CAS
2021年第2期93-98,共6页
Parasitoses and Infectious Diseases
关键词
并殖吸虫病
误诊
流行病学
治疗
paragonimiasis
misdiagnosis
epidemiology
treatment
