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目的分析6例输入性曼氏血吸虫病患者的临床特点,为提高临床医师的诊治水平提供资料依据。方法收集2009年1月-2016年7月确诊的6例输入性曼氏血吸虫病患者的临床资料,并进行分析。结果 6例输入性曼氏血吸虫病患者均有明确的流行病学史。主要临床表现为发热和嗜酸性粒细胞增高,50%患者伴有腹泻;肠黏膜组织压片均可以找到曼氏血吸虫卵,但日本血吸虫IgG抗体阳性率仅为33.3%。所有患者CD3~+CD8~+T细胞比例明显下降,B细胞比例明显上调,血免疫球蛋白以IgG抗体为主;16.6%的患者腹部超声见腹腔积液或脾脏增厚,16.6%患者磁共振检查见肝脏出现多发小结节或肠壁增厚,所有患者电子结肠镜检查均可见结肠炎,其中66.6%的患者合并多发溃疡,肠黏膜病理学均可见大量嗜酸性粒细胞浸润。6例患者经吡喹酮治疗后均达到临床治愈标准。结论本文通过系统总结6例输入性曼氏血吸虫病患者的流行病学史、临床和实验室多方面资料,为提高临床医师对该病的认知及诊治水平提供依据。
Objective To analyze the clinical features of 6 cases of imported Schistosoma mansoni in order to provide evidence for improving the diagnosis and treatment of clinicians. Methods The clinical data of 6 cases of imported Schistosoma mansoni from January 2009 to July 2016 were collected and analyzed. Results Six cases of enteritis schistosomiasis patients have a clear history of epidemiology. The main clinical manifestations of fever and eosinophilia, 50% of patients with diarrhea; intestinal mucosa can be found schistosomiasis tablets, but the positive rate of Schistosoma japonicum IgG antibody was only 33.3%. The proportion of CD3 ~ + CD8 ~ + T cells in all patients was significantly decreased, the proportion of B cells was significantly increased, and the IgG antibodies were the major immunoglobulin. In 16.6% of the patients, abdominal ultrasonography showed ascites or thickened spleen, 16.6% Multiple liver nodules or thickening of the bowel wall were observed. All patients underwent electron colonoscopy with colitis. Among them, 66.6% of patients had multiple ulceration and a large number of eosinophils infiltrated in the pathology of intestinal mucosa. 6 patients after praziquantel treatment to achieve clinical cure standards. Conclusion In this paper, by systematically summarizing the epidemiological history, clinical and laboratory data of 6 cases of imported Schistosoma mansoni, this study provided the basis for improving clinicians’ cognition and diagnosis and treatment of the disease.