肝囊型包虫病患者的临床特点分析
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摘要
目的总结172例包虫四项阳性组和阴性组患者临床特点,为肝囊型包虫病的诊治提供参考。方法收集172例肝囊型包虫病手术患者的资料,并分为包虫四项阳性组和阴性组,从流行病学、临床特征、影像学及血清学检查等方面进行分析。结果牧区居住和接触犬类是患者感染的重要途径。包虫活性越高,包虫囊肿个数越多,对肝脏损害越严重,越容易出现包虫四项阳性反应。结论通过对肝囊型包虫病患者的综合分析,更进一步认识和了解包虫病的临床特点,并对临床诊断和采取不同手术方式提供参考。
Objective The clinical features of 172 patients with hepatic cystic echinococcosis were summarized according to the four detection indexes for hydatid in order to provide reference for diagnosis and treatment.Methods The data of 172 patients with hepatic cystic echinococcosis were collected and divided into two groups according to the level of four antibodies(EgCF,EgP,EgB,Em2).In one group,the four antibodies were positive,while in the other group they were negative.The epidemiological,clinical characteristics,imaging and serological examination were analyzed.Results Living in pastoral areas and have close interaction with dogs is an important way of infection.The high activity and the number of hydatid can cause serious damage to the liver,and increase the risk of positive reactions of four antibodies.Conclusion Through the comprehensive analysis of patients with hepatic cystic echinococcosis,we obtained better understanding of the clinical features of hydatid disease.This study may provide reference for diagnosis and treatment by different surgical methods.
Objective The clinical features of 172 patients with hepatic cystic echinococcosis were summarized according to the four detection indexes for hydatid in order to provide reference for diagnosis and treatment.Methods The data of 172 patients with hepatic cystic echinococcosis were collected and divided into two groups according to the level of four antibodies(EgCF,EgP,EgB,Em2).In one group,the four antibodies were positive,while in the other group they were negative.The epidemiological,clinical characteristics,imaging and serological examination were analyzed.Results Living in pastoral areas and have close interaction with dogs is an important way of infection.The high activity and the number of hydatid can cause serious damage to the liver,and increase the risk of positive reactions of four antibodies.Conclusion Through the comprehensive analysis of patients with hepatic cystic echinococcosis,we obtained better understanding of the clinical features of hydatid disease.This study may provide reference for diagnosis and treatment by different surgical methods.
引文
[1]郭忠帅,张峰波,向阳,等.IL-18及IL-18结合蛋白、IFN-γ等血清炎性介质在囊型包虫病致Th1/Th2细胞偏移中的意义[J].新疆医科大学学报,2016,39(4):431-436.
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[10]ZHANG F,LI S,ZHU Y,et al.Immunization of mice with egG1Y162-1/2 provides protection against Echinococcus granulosus infection in BALB/c mice[J].Mol Immunol,2018,94(2):183-189.
[11]PANG N,ZHANG F,LI S,et al.TGF-β/Smad signaling pathway positively up-regulates the differentiation of Interleukin-9-producing CD4+T cells in human Echinococcus granulosus infection[J].J Infect,2018,76(4):406-416.
[12]李艳华,王晶,胡晓安,等.棘球蚴病患者血清中可溶性PD-1/PD-L1与相关细胞因子的水平变化[J].细胞与分子免疫学杂志,2014,30(4):421-423.
[13]ZHANG F,PANG N,ZHU Y,et al.CCR7(lo)PD-1(hi)CX-CR5(+)CD4(+)T cells are positively correlated with levels of IL-21 in active and transitional cystic echinococcosis patients[J].BMC Infect Dis,2015,26(10):457.
[14]安梦婷,吾拉木·马木提,马海梅,等.细粒棘球蚴AgB1、AgB2、AgB4抗原表位的特性分析[J].新疆医科大学学报,2016,39(12):1541-1546.
[15]赵慧,张峰波,庞楠楠.Tim-3/Galectin-9与Th1/Th2相关因子在人细粒棘球蚴感染中的表达研究[J].新疆医科大学学报,2016,39(3):313-319.
[16]王泽锋,张俊晶,耿亚军.肝囊型包虫病的影像学特征与诊断[J].中华消化外科杂志,2015,14(11):963-967.
[17]温浩.肝包虫病诊断和手术治疗新进展[J].中华消化外科杂志,2011,10(4):290-292.
[18]SARKAR S,ROY H,SAHA P,et al.Cystic echinococcosis:A neglected disease at usual and unusual locations[J].Trop Parasitol,2017,7(1):51-55.
[19]SHERA TA,CHOH NA,GOJWARITA,et al.A comparison of imaging guided double percutaneous aspiration injection and surgery in the treatment of cystic echinococcosis of liver[J].Br J Radiol,2017,90(1072):20160640.
[20]李全元,吴纲.493例包虫病手术病例的临床特征及疾病转归分析[J].实用医学杂志,2018,34(5):832-835.
[21]崔红权.血清ALT、AST、GGT检测在肝脏疾病诊断中应用研究[J].国际检验医学杂志,2017,38(16):2293-2295.
[22]黎明高.肝脏疾病诊断中采取血清ALT、AST、GGT检测的临床应用[J].中外医学研究,2018,16(11):179-181.
[2]庞楠楠,刘朝华,张峰波,等.Th9细胞和白介素-9在细粒棘球蚴感染患者中的变化特点及意义[J].免疫学杂志,2014,30(1):49-52.
[3]耿新惠,张峰波,姜敏,等.IL-21/BCL-6/Blimp-1在囊性包虫病中的表达特点研究[J].中国免疫学杂志,2018,34(3):412-417.
[4]曹文艳,师晓莉,曹明宇,等.新疆某三甲级医院包虫病流行病学的现状和特征分析[J].新疆医科大学学报,2014,37(9):1204-1207.
[5]TAMAROZZI F,COVINI I,MARICONTI M,et al.Accuracy of three rapid tests for the sero diagnosis of hepatic cystic echinococcosis in humans[J].PLoS Negl Trop Dis,2016,10(2):e0004444.
[6]中国医师协会外科医师分会包虫病外科专业委员会.肝两型包虫病诊断与治疗专家共识(2015版)[J].中华消化外科杂志,2015,14(4):253-264.
[7]赵慧,王亮,张峰波,等.细粒棘球蚴感染者中Tim-3+CD4+CD25+Treg细胞及相关因子的表达[J].免疫学杂志,2018,34(6):513-518.
[8]王玲玲,马海梅,丁剑冰,等.棘球蚴TGF-β/Smad和MAPK信号通路的研究进展[J].中国寄生虫学与寄生虫病杂志,2018,36(5):516-519.
[9]庞楠楠,安梦婷,张峰波.细粒棘球蚴感染中TGF-β/Smad信号通路对IL-9调控作用的研究[J].中国寄生虫学与寄生虫病杂志,2018,36(4):460-464.
[10]ZHANG F,LI S,ZHU Y,et al.Immunization of mice with egG1Y162-1/2 provides protection against Echinococcus granulosus infection in BALB/c mice[J].Mol Immunol,2018,94(2):183-189.
[11]PANG N,ZHANG F,LI S,et al.TGF-β/Smad signaling pathway positively up-regulates the differentiation of Interleukin-9-producing CD4+T cells in human Echinococcus granulosus infection[J].J Infect,2018,76(4):406-416.
[12]李艳华,王晶,胡晓安,等.棘球蚴病患者血清中可溶性PD-1/PD-L1与相关细胞因子的水平变化[J].细胞与分子免疫学杂志,2014,30(4):421-423.
[13]ZHANG F,PANG N,ZHU Y,et al.CCR7(lo)PD-1(hi)CX-CR5(+)CD4(+)T cells are positively correlated with levels of IL-21 in active and transitional cystic echinococcosis patients[J].BMC Infect Dis,2015,26(10):457.
[14]安梦婷,吾拉木·马木提,马海梅,等.细粒棘球蚴AgB1、AgB2、AgB4抗原表位的特性分析[J].新疆医科大学学报,2016,39(12):1541-1546.
[15]赵慧,张峰波,庞楠楠.Tim-3/Galectin-9与Th1/Th2相关因子在人细粒棘球蚴感染中的表达研究[J].新疆医科大学学报,2016,39(3):313-319.
[16]王泽锋,张俊晶,耿亚军.肝囊型包虫病的影像学特征与诊断[J].中华消化外科杂志,2015,14(11):963-967.
[17]温浩.肝包虫病诊断和手术治疗新进展[J].中华消化外科杂志,2011,10(4):290-292.
[18]SARKAR S,ROY H,SAHA P,et al.Cystic echinococcosis:A neglected disease at usual and unusual locations[J].Trop Parasitol,2017,7(1):51-55.
[19]SHERA TA,CHOH NA,GOJWARITA,et al.A comparison of imaging guided double percutaneous aspiration injection and surgery in the treatment of cystic echinococcosis of liver[J].Br J Radiol,2017,90(1072):20160640.
[20]李全元,吴纲.493例包虫病手术病例的临床特征及疾病转归分析[J].实用医学杂志,2018,34(5):832-835.
[21]崔红权.血清ALT、AST、GGT检测在肝脏疾病诊断中应用研究[J].国际检验医学杂志,2017,38(16):2293-2295.
[22]黎明高.肝脏疾病诊断中采取血清ALT、AST、GGT检测的临床应用[J].中外医学研究,2018,16(11):179-181.