目的探讨云南省大理州人群感染大片形吸虫的疫情特征，为片形吸虫病预防控制提供科学依据。方法收集疫情资料，了解患者的临床表现和症状。采用酶联免疫吸附法（ELISA）对患者、部分家属及同村的健康人进行血清学大片吸虫可溶性成虫抗...目的探讨云南省大理州人群感染大片形吸虫的疫情特征，为片形吸虫病预防控制提供科学依据。方法收集疫情资料，了解患者的临床表现和症状。采用酶联免疫吸附法（ELISA）对患者、部分家属及同村的健康人进行血清学大片吸虫可溶性成虫抗原检测和显微镜下粪便虫卵检查，并对检出的虫卵进行测序和PCR扩增。将测序结果进入美国国立生物技术信息中心（NCBI）中的BLAST（basic local alignment search tool）程序进行核酸序列比对，比较二者的相似性。对患者给予三氯苯达唑治疗，治疗剂量为10mg·kg^-1·d^-1，每天1次口服，连续用药2d，服药后留院观察1周。在大理州城镇周边水沟处进行宿主和媒介调查，采集宿主椎实螺，进行压片检查，在有椎实螺分布环境中采集牛粪和羊粪，用水洗沉淀法，在显微镜下检查粪便中的虫卵。结果26例患者均以高热起病。发热持续，嗜酸性粒细胞升高，伴不同程度的恶心、呕吐、腹痛、纳差等消化系统症状；肝肿大、肝区叩痛，肝脏CT均有不同程度损伤，。患者均有生食过鱼腥草等水生植物史，且病程相近，具有相同的流行病学特征。ELISA检测血清大片吸虫可溶性成虫抗原，26例患者阳性率为100．0％（26／26），家属阳性率为31．6％（18／57），同村健康人阳性率为17．1％（6／35）。虫卵经测序和BLAST分析结果显示，与大片形吸虫的相似性为99％～100％。PCR扩增也进一步证实虫卵为大片吸虫虫卵，在约1000bp处出现明显的条带。三氯苯达唑治疗后．患者体温降至正常，自觉症状明显好转。在大理州城镇周边水沟处共采集329只椎实螺，在其中5只螺体内查到吸虫类雷蚴及单尾型尾蚴，初步鉴定为大片形吸虫幼虫。在1份牛粪和1份羊粪中查见大片形吸虫卵。结论生食被大片形吸虫卵感染的水生植物是导致发病的主要原因展开更多
AIM:To identify the characteristic clinical,laboratory and radiological findings and response to treatment in patients with fascioliasis.METHODS:Patients who were diagnosed with Fasciola hepatica infection were includ...AIM:To identify the characteristic clinical,laboratory and radiological findings and response to treatment in patients with fascioliasis.METHODS:Patients who were diagnosed with Fasciola hepatica infection were included in this prospective study.Initial clinical,laboratory and radiological findings were recorded.All patients were followed until a complete response was achieved or for 6 mo after treatment discontinuation.RESULTS:Fasciola hepatica infection was diagnosed in 30 patients(24 females;mean age:42.6 years) between January 2008 and February 2011.Twentytwo(73%) patients had hepatic phase fascioliasis,5 patients had biliary phase,and 3 patients had biliary phase associated with acute pancreatitis.Of the 8 patients with biliary phase fascioliasis,2 patients displayed features that overlapped with both hepatic and biliary phase.Abdominal pain and right upper abdominal tenderness were the most prominent signs and symptoms in all patients.Eosinophilia was the most prominent laboratory abnormality in both patients with hepatic and biliary phase(100% and 50%,respectively).Multiple nodular lesions like micro-abscesses on abdominal computerized tomography were the main radiological findings in patients with hepatic phase.Small linear filling defects in the distal choledochus were the main endoscopic retrograde cholangiopancreatography(ERCP) findings in patients with biliary phase.Patients with hepatic phase were treated with triclabendazole alone,and patients with biliary phase were treated with triclabendazole and had live Fasciola hepatica extracted from the bile ducts during ERCP.CONCLUSION:Fasciola hepatica infection should be considered in the differential diagnosis of patients with hepatic or biliary disease and/or acute pancreatitis associated with eosinophilia.展开更多
Objective To observe triclabendazole effect on Paragonimus skrjabini in experimentally infected rats, and to develop a new drug for treating paragonimiasis.Methods Metacercariae of Paragonimus skrjabini were isolated ...Objective To observe triclabendazole effect on Paragonimus skrjabini in experimentally infected rats, and to develop a new drug for treating paragonimiasis.Methods Metacercariae of Paragonimus skrjabini were isolated from crabs (Sinopotamon) collected from endemic area. Wistar rats were infected intraperitoneally. One and two months after infection, they were treated with triclabendazole at the dosage of 300 mg · kg -1 · 2d-1, 450 mg ·kg -1 · 3d -1 and 600 mg · kg-1 · 3d-1 respectively. Five patients with Paragonimus skrjabini were treated, with Triclabendazole dosage of 10 mg/kg bid x3 days.Results The worm reduction rates were 50. 3%, 80. 8% and 86. 7% respectively one month after completion of treatment. Dead worms of sesame size recovered from muscles, liver, abdominal cavity, chest cavity and lung were greatly diminished in size and weight in comparison with that of the control group. Many large (about 1 cm) black-colored distended worm cysts were found in the lungs of the control rats. Usually there were two adult worms pairs with numerous eggs in each worm cyst. Most worm cysts in the treated groups of rats were changed into hemorrhagic-necrotic patches. All five patients were cured.Conclusion Triclabendazole was highly active against Paragonimus skrjabini in rats experimentally infected and patients.展开更多
文摘目的探讨云南省大理州人群感染大片形吸虫的疫情特征，为片形吸虫病预防控制提供科学依据。方法收集疫情资料，了解患者的临床表现和症状。采用酶联免疫吸附法（ELISA）对患者、部分家属及同村的健康人进行血清学大片吸虫可溶性成虫抗原检测和显微镜下粪便虫卵检查，并对检出的虫卵进行测序和PCR扩增。将测序结果进入美国国立生物技术信息中心（NCBI）中的BLAST（basic local alignment search tool）程序进行核酸序列比对，比较二者的相似性。对患者给予三氯苯达唑治疗，治疗剂量为10mg·kg^-1·d^-1，每天1次口服，连续用药2d，服药后留院观察1周。在大理州城镇周边水沟处进行宿主和媒介调查，采集宿主椎实螺，进行压片检查，在有椎实螺分布环境中采集牛粪和羊粪，用水洗沉淀法，在显微镜下检查粪便中的虫卵。结果26例患者均以高热起病。发热持续，嗜酸性粒细胞升高，伴不同程度的恶心、呕吐、腹痛、纳差等消化系统症状；肝肿大、肝区叩痛，肝脏CT均有不同程度损伤，。患者均有生食过鱼腥草等水生植物史，且病程相近，具有相同的流行病学特征。ELISA检测血清大片吸虫可溶性成虫抗原，26例患者阳性率为100．0％（26／26），家属阳性率为31．6％（18／57），同村健康人阳性率为17．1％（6／35）。虫卵经测序和BLAST分析结果显示，与大片形吸虫的相似性为99％～100％。PCR扩增也进一步证实虫卵为大片吸虫虫卵，在约1000bp处出现明显的条带。三氯苯达唑治疗后．患者体温降至正常，自觉症状明显好转。在大理州城镇周边水沟处共采集329只椎实螺，在其中5只螺体内查到吸虫类雷蚴及单尾型尾蚴，初步鉴定为大片形吸虫幼虫。在1份牛粪和1份羊粪中查见大片形吸虫卵。结论生食被大片形吸虫卵感染的水生植物是导致发病的主要原因
文摘AIM:To identify the characteristic clinical,laboratory and radiological findings and response to treatment in patients with fascioliasis.METHODS:Patients who were diagnosed with Fasciola hepatica infection were included in this prospective study.Initial clinical,laboratory and radiological findings were recorded.All patients were followed until a complete response was achieved or for 6 mo after treatment discontinuation.RESULTS:Fasciola hepatica infection was diagnosed in 30 patients(24 females;mean age:42.6 years) between January 2008 and February 2011.Twentytwo(73%) patients had hepatic phase fascioliasis,5 patients had biliary phase,and 3 patients had biliary phase associated with acute pancreatitis.Of the 8 patients with biliary phase fascioliasis,2 patients displayed features that overlapped with both hepatic and biliary phase.Abdominal pain and right upper abdominal tenderness were the most prominent signs and symptoms in all patients.Eosinophilia was the most prominent laboratory abnormality in both patients with hepatic and biliary phase(100% and 50%,respectively).Multiple nodular lesions like micro-abscesses on abdominal computerized tomography were the main radiological findings in patients with hepatic phase.Small linear filling defects in the distal choledochus were the main endoscopic retrograde cholangiopancreatography(ERCP) findings in patients with biliary phase.Patients with hepatic phase were treated with triclabendazole alone,and patients with biliary phase were treated with triclabendazole and had live Fasciola hepatica extracted from the bile ducts during ERCP.CONCLUSION:Fasciola hepatica infection should be considered in the differential diagnosis of patients with hepatic or biliary disease and/or acute pancreatitis associated with eosinophilia.
文摘Objective To observe triclabendazole effect on Paragonimus skrjabini in experimentally infected rats, and to develop a new drug for treating paragonimiasis.Methods Metacercariae of Paragonimus skrjabini were isolated from crabs (Sinopotamon) collected from endemic area. Wistar rats were infected intraperitoneally. One and two months after infection, they were treated with triclabendazole at the dosage of 300 mg · kg -1 · 2d-1, 450 mg ·kg -1 · 3d -1 and 600 mg · kg-1 · 3d-1 respectively. Five patients with Paragonimus skrjabini were treated, with Triclabendazole dosage of 10 mg/kg bid x3 days.Results The worm reduction rates were 50. 3%, 80. 8% and 86. 7% respectively one month after completion of treatment. Dead worms of sesame size recovered from muscles, liver, abdominal cavity, chest cavity and lung were greatly diminished in size and weight in comparison with that of the control group. Many large (about 1 cm) black-colored distended worm cysts were found in the lungs of the control rats. Usually there were two adult worms pairs with numerous eggs in each worm cyst. Most worm cysts in the treated groups of rats were changed into hemorrhagic-necrotic patches. All five patients were cured.Conclusion Triclabendazole was highly active against Paragonimus skrjabini in rats experimentally infected and patients.
