肝吸虫病合并胆道多发性结石和胆汁淤积性肝硬化误诊为布加综合征1例报告
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摘要
<正>肝吸虫病,又称华支睾吸虫病,是常见的食源性寄生虫病。其临床主要表现为胆管炎、胆囊炎、胆石症等,也可引起多种并发症,如胆道梗阻、脓肿、胆管癌等~([1-2])。当疾病进展至晚期,肝脏形态学发生改变,肿大的肝脏压迫肝内血管可导致肝脏淤血改变,继发肝静脉或下腔静脉阻塞性疾病,类似布加综合征。本例患者最初即被误诊为布加综合征,现报道如下。1病例资料患者女性,24岁,因"发现肝功能异常3年余,面黄、目黄4
引文
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[5]XIE M,FENG QC.Analysis of the clinical features of 196clonorchiasis patients and the causes of misdiagnosis[J].China Trop Med,2006,6(11):2002-2004.(in Chinese).谢敏,冯倩嫦.华支睾吸虫病196例临床特点与误诊分析[J].中国热带医学,2006,6(11):2002-2004.
[6]HERNANDEZ-GEA V,FRIEDMAN SL.Pathogenesis of liver fibrosis[J].Annu Rev Pathol,2011,6:425-456.
[7]YAN C,WANG YH,YU Q,et al.Clonorchis sinensis excretory/secretory products promote the secretion of TNF-alpha in the mouse intrahepatic biliary epithelial cells via Toll-like receptor 4[J].Parasit Vectors,2015,8:559.
[8]XU Y,LIN J,BIAN M,et al.CsRNASET2 is an important component of Clonorchis sinensis responsible for eliciting Th2 immune response[J].Parasitol Res,2015,114(6):2371-2379.
[9]CHIARAMONTE MG,DONALDSON DD,CHEEVER AW,et al.An IL-13 inhibitor blocks the development of hepatic fibrosis during a T-helper type 2-dominated inflammatory response[J].J Clin Invest,1999,104(6):777-785.
[10]WYNN TA.Fibrotic disease and the T(H)1/T(H)2 paradigm[J].Nat Rev Immunol,2004,4(8):583-594.
[11]ZHOU L,SHI M,ZHAO L,et al.Clonorchis sinensis lysophospholipase A upregulates IL-25 expression in macrophages as a potential pathway to liver fibrosis[J].Parasit Vectors,2017,10(1):295.
[12]QIAN MB,UTZINGER J,KEISER J,et al.Clonorchiasis[J].Lancet,2016,387(10020):800-810.
[2]ZHANG H,ZHU L,WANG L,et al.Clinical analysis of 22 patients with hepatobiliary disease caused by liver fluke[J].J Clin Hepatol,2013,29(7):538-540.(in Chinese)张会,朱磊,王璐,等.肝吸虫性肝胆疾病22例分析[J].临床肝胆病杂志,2013,29(7):538-540.
[3]YANG YC,LI SL,TAN YG,et al.Infection status of Haplorchis taichui in the population and freshwater fish in liver fluke endemic areas of Guangxi[J].J Appl Prev Med,2012,18(2):75-77.(in Chinese)杨益超,李树林,谭裕光,等.广西肝吸虫流行区人群及淡水鱼扇棘单睾吸虫感染调查[J].应用预防医学,2012,18(2):75-77.
[4]HONG ST,PARK KH,SEO M,et al.Correlation of sonographic findings with histopathological changes of the bile ducts in rabbits infected with Clonorchis sinensis[J].Korean J Parasitol,1994,32(4):223-230.
[5]XIE M,FENG QC.Analysis of the clinical features of 196clonorchiasis patients and the causes of misdiagnosis[J].China Trop Med,2006,6(11):2002-2004.(in Chinese).谢敏,冯倩嫦.华支睾吸虫病196例临床特点与误诊分析[J].中国热带医学,2006,6(11):2002-2004.
[6]HERNANDEZ-GEA V,FRIEDMAN SL.Pathogenesis of liver fibrosis[J].Annu Rev Pathol,2011,6:425-456.
[7]YAN C,WANG YH,YU Q,et al.Clonorchis sinensis excretory/secretory products promote the secretion of TNF-alpha in the mouse intrahepatic biliary epithelial cells via Toll-like receptor 4[J].Parasit Vectors,2015,8:559.
[8]XU Y,LIN J,BIAN M,et al.CsRNASET2 is an important component of Clonorchis sinensis responsible for eliciting Th2 immune response[J].Parasitol Res,2015,114(6):2371-2379.
[9]CHIARAMONTE MG,DONALDSON DD,CHEEVER AW,et al.An IL-13 inhibitor blocks the development of hepatic fibrosis during a T-helper type 2-dominated inflammatory response[J].J Clin Invest,1999,104(6):777-785.
[10]WYNN TA.Fibrotic disease and the T(H)1/T(H)2 paradigm[J].Nat Rev Immunol,2004,4(8):583-594.
[11]ZHOU L,SHI M,ZHAO L,et al.Clonorchis sinensis lysophospholipase A upregulates IL-25 expression in macrophages as a potential pathway to liver fibrosis[J].Parasit Vectors,2017,10(1):295.
[12]QIAN MB,UTZINGER J,KEISER J,et al.Clonorchiasis[J].Lancet,2016,387(10020):800-810.