上海市综合性医院腹泻患者中溶组织内阿米巴感染现状调查

目的了解综合性医院腹泻患者溶组织内阿米巴感染现状,为防治工作提供科学依据。方法选择上海市3所综合性医院肠道门诊,采集门诊腹泻患者新鲜粪便和血清,分别采用生理盐水涂片法和碘液染色法、免疫层析法、ELISA法进行检测,以了解腹泻患者溶组织内阿米巴感染状况,并对感染者特征进行分析。结果检测腹泻患者粪便样本1 015份,检出溶组织内阿米巴原虫病原学阳性36份,总阳性率为3.55%。3所医院腹泻患者病原学阳性率间差异无统计学意义(P0.05),溶组织内阿米巴阳性者性别、年龄、职业和文化程度分布差异均无统计学意义(P均0.05),脓血便中溶组织内阿米巴阳性率显著高于稀便和水样便(P均0.01)。7-9月为发病高峰。88.90%的阳性者有腹痛,75.00%和22.23%的阳性者粪便查见白细胞和红细胞。试剂条法检测溶组织内阿米巴粪抗原阳性率为8.18%(83/1 015),ELISA法检测溶组织内阿米巴Ig G抗体阳性率为7.12%(48/675)。结论夏秋季是溶组织内阿米巴感染高发季节,应加强监测;脓血便中溶组织内阿米巴检出阳性率较高,联合应用多种检测手段能提高检出率。

Investigation on Entamoeba histolytica infection in diarrhea patients from general hospitals in Shanghai City

Objective To understand the status of Entamoeba histolytica infection in diarrhea patients in general hospitals， so as to provide the evidences for the prevention and control of the disease. Methods The diarrhea patients in intestinal disease clinics of 3 general hospitals in Shanghai City were chosen as the investigation objectives， and their fecal and blood samples were collected， and then were detected by the normal saline direct smear method and iodine solution staining， immunochromatographic?method and ELISA respectively to understand the infection status of E. histolytica， and the characteristics of the infected persons were analyzed. Results Totally 1 015 fecal samples were detected， and among which 36 positive ones were detected by parasitological examinations， with a general positive rate of 3.55%. There were no statistically significant differences among the positive rates of patients from the three hospitals（P > 0.05）， nor between or among those of the patients with different sexes， ages， occupations and education levels（all P > 0.05）. The positive rate of E. histolytica in bloody purulent stools was higher than those in loose stools and watery stools（both P < 0.01）. The peak period of infection was from July to September. Among the 36 infected people detected by parasitological examination， 88.90% of them complained about abdominal pain， and the red blood cells and leucocyte cells were found in the stool samples of 75.00% and 22.23% of the cases， respectively. The positive rates of E. histolytica were 8.18%（83/1 015）and 7.12%（48/675） respectively when detected by the immunochromatographic?method and ELISA. Conclusions Summer and autumn are the high risk seasons for E. histolytica infection， and the surveillance should be strengthened in this period. The positive rate of E. histolytica in samples of bloody purulent stools is high， and the combined application of several detection methods can increase the detection rate.