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目的了解多发脑囊尾蚴病临床特点,分析患者不同疗程中血清囊虫Ig G抗体变化,为多发脑囊尾蚴病诊治提供依据。方法分析2007年12月—2012年2月就诊于大理州血吸虫病防治所的多发脑囊尾蚴病患者的临床特点。在患者抗虫治疗过程中采用ELISA法检测每个疗程中血清囊虫Ig G抗体,分析不同疗程中血清抗体的动态变化。结果共收集多发脑囊尾蚴病89例,其中白族患者占48.31%,60.67%的患者有食“生皮”史,62.92%的患者有癫痫发作史。3个疗程后复查头颅CT或MRI发现7例(包括2例癫痫发作者)为囊虫活动病灶合并钙化,治疗总有效率为92.13%(82/89);在第一、二、三疗程结束后血清Ig G抗体阳性率分别为62.92%、65.17%和69.66%,第三疗程血清Ig G抗体阳性率明显高于第一疗程(P<0.05)。结论进食“生皮”仍是大理地区多发脑囊尾蚴病流行的高危因素,患者以男性、白族为主;血清囊虫Ig G抗体可用于临床辅助诊断和流行病学调查。
Objective To understand the clinical features of multiple cerebral cysticercosis and to analyze the changes of Ig G antibodies in different courses of patients and to provide evidence for the diagnosis and treatment of multiple cerebral cysticercosis. Methods The clinical features of multiple cerebral cysticercosis patients who were admitted to Dali State Schistosomiasis Prevention and Treatment Institute from December 2007 to February 2012 were analyzed. Serum cysticercosis Ig G antibody was detected by ELISA in patients during the course of pest-resistant treatment, and the dynamic changes of serum antibodies in different courses were analyzed. Results A total of 89 cases of multiple cysticercosis were collected, of which Bai accounted for 48.31%, 60.67% had a history of eating skin, and 62.92% had history of seizures. After 3 courses of reviewing craniocerebral CT or MRI, 7 cases (including 2 cases of seizures) were found to be active cysticercosis with calcification. The total effective rate was 92.13% (82/89). After the first, second and third courses were over The positive rates of Ig G antibodies in serum after the first course of treatment were 62.92%, 65.17% and 69.66% respectively. The positive rate of serum Ig G antibody in the third course of treatment was significantly higher than that of the first course of treatment (P <0.05). Conclusions Eating “hides and skins” is still a high risk factor for multiple brain cysticercosis in Dali. The patients are predominantly male and white. Serum cysticercosis Ig G antibodies can be used in clinical diagnosis and epidemiological investigation.