摘要
目的探讨呼吸道疾病感染致病原—蠊缨滴虫的相关流行病学特征,为蠊缨滴虫的预防和治疗提供相应依据。方法自2011年6月至2015年3月随机对361例呼吸道感染性疾病患者进行痰涂片及支气管灌洗液进行蠊缨滴虫检验,检出阳性患者117例。回顾性分析117例蠊缨滴虫感染患者的临床资料,分析其一般临床表现、蠊缨滴虫滋养体及包囊形态特点、治疗和转归情况。结果蠊缨滴虫检出率为32.41%(117/361),不同性别蠊缨滴虫检出率比较,无显著差异(P>0.05),不同疾病患者的蠊缨滴虫检出率有差异(P<0.05)。患者均有阵发性、刺激性咳嗽、咳痰、胸闷、气促;大多患者X线表现为肺纹理增粗、紊乱;所有患者漱口液离心镜检未发现蠊缨滴虫,痰液细菌培养100例无致病菌生长,真菌培养阳性11例,细菌培养阳性6例。肝肾功能、尿常规均在正常范围。血常规检查有76例嗜酸性粒细胞有不同程度的增高。因发育阶段及其观察时视角不同其形态各异,有圆形、椭圆形、乌贼鱼形、虱形、石榴形等多种形态;包囊呈圆形或不规整椭圆形,大小12~35μm,壁较厚,单层。50例随访患者经过半年随访后总的治愈率(无复发)为46.00%(23/50),复发率为34.30%(12/35)。结论蠊缨滴虫在环境不利于生长繁殖的情况下可形成包囊,致病性降低,而当环境条件适宜时则变为滋养体,致病性增强,这是蠊缨滴虫感染者病情反复复发,病程迁延不愈的原因之一,目前对于蠊缨滴虫的临床治疗还需进一步研究。
ABSTRACT： Objective To investigate the epidemiological characteristics of respiratory tract infection pathogens-lophomonas blattarum, and to provide the basis for the prevention and treatment of lophomonas blattarum. Methods From June 2011 to March 2015, 361 patients with respiratory tract infection were randomly selected for sputum smear and bronchial lavage fluid testing for lophomonas blattarum, 117 cases were positive. The clinical data of the 117 cases were retrospectively analyzed, including the general clinical manifestations, morphological characteristics of trophozoite and cysts of lophomonas blattarum, treatment and prognosis. Results The detection rate of lophomonas blattarum was 32.41% （117/361）, there was no significant difference in the detection rate of different sexes （P〉0.05）, the detection rate of different diseases was significant （P〈0.05）. Patients had paroxysmal, irritating cough, sputum, chest tightness, shortness of breath; the X-ray showed the lung markings were thickened and disordered; no lophomonas blattarum was found in the mouthwash of all patients, no pathogenic bacterium growed in 100 cases of putum bacterial culture, 11 cases of fungus culture were positive, 6 cases of bacterial culture were positive; the liver and kidney function, urine were in normal, blood routine examination showed 76 cases had eosinophils increas in varying degrees. There were round, oval, squid fish, lice, pomegranate and other forms of lophomonas blattarum because of different developmental stage and observation angle; cysts were round or irregular oval, 12-35 μm, thick wall, single layer. The overall cure rate （no recurrence） was 46.00% （23/50） and the recurrence rate was 34.30% （12/35） after half a year follow-up. Conclusion Lophomonas blattarum can form cysts when the environment is not conducive to the growth and reproduction, and its pathogenicity decrease, and when the environmental conditions are appropriate, trophozoites formed and its pathogenicity increase, that is one of the causes of the recurrence of the disease, at present, the clinical treatment of lophomonas blattarum need further study.
出处
《临床医学研究与实践》
2017年第32期7-9,共3页
Clinical Research and Practice
关键词
蠊缨滴虫
感染
滋养体
包囊
传播途径
lophomonas blattarum
infection
trophozoites
cyst
route of transmission
