Cystic echinococcosis (CE) is a widely endemic helminthic disease caused by infection with metacestodes (larval stage)of the Echinococcus granulosus tapeworm.E.granulosus are common parasites in certain parts of the w...Cystic echinococcosis (CE) is a widely endemic helminthic disease caused by infection with metacestodes (larval stage)of the Echinococcus granulosus tapeworm.E.granulosus are common parasites in certain parts of the world,and are present on every continent with the exception of Antarctica.As a result,a large number of people are affected by CE.The increased emigration of populations from endemic areas where prevalence rates are as high as 5-10% and the relatively quiescent clinical course of CE pose challenges for accurate and timely diagnoses.Upon infection with CE,cyst formation mainly occurs in the liver (70%).Diagnosis involves serum serologic testing for antibodies against hydatid antigens,but preferably with imaging by ultrasound or CT/MRI.Treatment methods include chemotherapy with benzimidazole carbamates and/or surgical approaches,including percutaneous aspiration injection and reaspiration.The success of these methods is influenced by the stage and location of hepatic cysts.However,CE can be clinically silent,and has a high risk for recurrence.It is important to consider the echinococcal parasite in the differential diagnosis of liver cystic lesions,especially in patients of foreign origin,and to perform appropriate long-term follow-ups.The aim of this review is to highlight the epidemiology,natural history,diagnostic methods,and treatment of liver disease caused by E.granulosus.展开更多
回顾性分析2015年如皋市符合纳入标准的648例新发结核病患者结核性药物不良反应（adverse drug reactions，ADR）的发生情况及影响因素。所有患者资料[患者一年来所有的结核病门诊及住院患者的临床资料（包括临床医嘱单，病史资料，用...回顾性分析2015年如皋市符合纳入标准的648例新发结核病患者结核性药物不良反应（adverse drug reactions，ADR）的发生情况及影响因素。所有患者资料[患者一年来所有的结核病门诊及住院患者的临床资料（包括临床医嘱单，病史资料，用药情况，实验室检查结果等）]均由结核科医师提供。研究发现，648例患者中发生药物不良反应者317例（48．9％），其中120例发生2种及t2种以上不良反应，共计519例次。最多见的不良反应为尿酸增高（42．4％，220／519），肝损伤（15．0％，78／519）及胃肠道反应（13．5％，70／519）。在抗结核药物中，吡嗪酰胺引起的不良反应最高（49．9％，259／519），其次是利福平（16．6％，86／519）；其中207例（65．3％）发生在强化期，110例（34．7％）发生在巩固期。78例（24．6％）患者因不良反应需要调整治疗方案，其中17例（5．4％）因严重不良反应中断治疗。多因素回归分析表明，高龄（β=1．18，Wald χ^2=63．27，P〈0．001，OR=3．25，95％CI=2．43-4．35）、肝病史（=1．62，Wald χ^2=22．51，P〈0．001，OR=5．03，95％CI=2．58-9．81）、糖尿病病史（β=1．85，Wald χ^2=29．48，P〈0．001，OR=6．37，95％CI=3．26-12．42）、饮酒史（β=1．39，Wald χ^2=17．69，P〈0．001，OR=1．39，95％CI=2．10-7．66）是影响药物不良反应的相关危险因素。故为保障临床用药安全，医生应熟知常见的抗结核药物的不良反应，加强患者对结核病防治知识及药物不良反应的宣传教育，根据患者年龄、病情等合理用药，尽量避免或减少药物不良反应的发生，并能够及时处理发生的药物不良反应。展开更多
文摘Cystic echinococcosis (CE) is a widely endemic helminthic disease caused by infection with metacestodes (larval stage)of the Echinococcus granulosus tapeworm.E.granulosus are common parasites in certain parts of the world,and are present on every continent with the exception of Antarctica.As a result,a large number of people are affected by CE.The increased emigration of populations from endemic areas where prevalence rates are as high as 5-10% and the relatively quiescent clinical course of CE pose challenges for accurate and timely diagnoses.Upon infection with CE,cyst formation mainly occurs in the liver (70%).Diagnosis involves serum serologic testing for antibodies against hydatid antigens,but preferably with imaging by ultrasound or CT/MRI.Treatment methods include chemotherapy with benzimidazole carbamates and/or surgical approaches,including percutaneous aspiration injection and reaspiration.The success of these methods is influenced by the stage and location of hepatic cysts.However,CE can be clinically silent,and has a high risk for recurrence.It is important to consider the echinococcal parasite in the differential diagnosis of liver cystic lesions,especially in patients of foreign origin,and to perform appropriate long-term follow-ups.The aim of this review is to highlight the epidemiology,natural history,diagnostic methods,and treatment of liver disease caused by E.granulosus.
