317例华支睾吸虫病流行特征分析

目的探讨华支睾吸虫病的临床流行病学特征变化，为制定进一步的防治策略提供理论基础。方法于2010年收集哈尔滨医科大学人体寄生虫病研究所就诊的疑似患者875人．采用Kato—Katz方法和酶联免疫方法分别对受检者的1950份粪便样本和875份血清样本进行检测，同时收集患者的基本信息。结果受检者中华支睾吸虫感染患者317例，感染率为36．23％，该病的流行多为散发病例。男性感染率为39．94％．明显高于女性的26．36％，差异有统计学意义（P〈0．001）。感染率随年龄增长而上升，20—69岁人群感染率较高，其中40—49岁人群感染率最高（42．71％）。农村患者感染率（42．27％）高于城市（20．33％），反复感染患者常见，吃生鱼（虾）习惯具有最高的感染风险（0R=28．507）。结论华支睾吸虫感染率较高，揭示该病流行病学特征和风险因素，将为加速控制和消灭华支睾吸虫病提供依据。     

哈尔滨市在校大学生面部蠕形螨感染调查

人体蠕形螨(human demodex)俗称毛囊虫,为蠕形螨科蠕型螨属,是寄生在人及其他哺乳动物的毛囊和皮脂腺内的一种条件致病性螨类.蠕形螨以皮肤的角质蛋白及细胞代谢产物为食,常侵犯人的颜面部如鼻、前额、颊部等皮脂发达的部位.蠕形螨呈世界性分布,人群普遍易感,国外报道人群感染率为27％～100％,国内报道感染率为0.8％～81％[1].近年来的研究表明,蠕形螨与一般皮肤病如酒渣鼻、痤疮及脂溢性皮炎等有一定关系[2].个人卫生习惯、皮肤类型与蠕形螨感染密切相关[3,4],具有居室聚集性,容易在人群中传播[5].为了了解当地在校大学生蠕形螨感染情况,我们对哈尔滨医科大学在校住宿的大学生进行了抽样调查,结果报告如下.     

细胞凋亡在肝吸虫感染大鼠及肝吸虫病患者肝损伤的作用

目的 分析肝吸虫感染大鼠和肝吸虫病患者肝组织的病理改变及损伤情况,探讨细胞凋亡在肝吸虫感染所致肝损伤中的作用.方法 将Wistar大鼠分为2组:感染组60只,对照组20只.感染组大鼠经口饲感染囊蚴法建立肝吸虫感染模型,对照组大鼠采用生理盐水灌胃.于感染后第4、6、8、12周时处死动物.同时收集尸检获得的肝吸虫病患者及健康对照人体肝组织标本各4例.光镜下观察大鼠和人体肝吸虫感染情况以及肝组织的病理学改变;并用TUNEL法检测肝细胞的凋亡率.结果 光镜下各时间点感染组大鼠和肝吸虫病患者胆管壁增厚,胆管黏膜呈乳头状和腺瘤样增生,管腔内可见虫体及虫卵,胆管周围可见炎细胞浸润和少量纤维组织增生,汇管区周围有一些肝细胞出现核固缩,呈现细胞凋亡的形态特征.感染组大鼠第4、6、8、12周时肝细胞凋亡率分别为(7.15±1.50)%、(11.61±3.09)%、(13.21±3.47)%、(11.26±4.06)%,均明显高于对照组[(2.57±0.72)%、(3.17±0.77)%、(3.67±0.96)%、(2.84±0.87)%,t值分别为4.45、5.49、5.95、4.74,P均<0.01].肝吸虫病患者肝组织细胞凋亡率为(12.02±1.78)%,明显高于对照组[(2.03±0.68)%,t=15.13,P<0.01].结论 肝吸虫感染可以引起宿主肝细胞凋亡,后者可能与感染者肝损伤有关.

Abstract：

Objective To investigate the liver injury and pathological changes of rat and patients with Clonorchis sinensis(C, sinensis) infection, and to clarify the role of apoptosis in the injury induced by C. sinensis.Methods Wistar rats were divided into two group: 60 in infection group and 20 in control. The rats in infection group were infected with C. sinensis via oral feeding encysted cercaria;rats in control group were fed with normal saline. The rats were sacrificed 4, 6, 8 and 12 weeks after infection, respectively. Liver tissue specimens of the patients infected with C. sinensis were collected. The pathological changes of liver tissue were observed by light microscopy and the apoptofic rate of hepatocyte was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL) assay. Results Parasites and eggs could he seen around the bile duct, and the duct was associated with mucosa and adenoma papillary hyperplasia, wall thickening, inflammatory cell infiltration, a small amount of fibrous tissue hyperplasia, and periportal liver cells surrounded by a number of nuclear condensation, all these changes meant morphological characteristics of apoptosis. Apoptotic rates of liver cells in infection group 4, 6,8 and 12 weeks after infection were (7.15 ± 1.50)%,(11.61 ± 3.09)%,(13.21 ± 3.47)% and (11.26 ± 4.06)%,respectively, which was significantly higher than that in control group [(2.57 ± 0.72)%, (3.17 + 0.77)%, (3.67 ±0.96)% and (2.84 ± 0.87)%, t values were 4.45, 5.49, 5.95 and 4.74, respectively, all P < 0.01]. Conclusions These findings indicate that C, sinensis can stimulate both hepatoeytic apoptosis and degeneration which may he related to clinical manifestations and liver lesions in patients with clonorchiasis.