热带病与寄生虫学

热带病与寄生虫学 ›› 2022, Vol. 20 ›› Issue (1): 24-27.

• 防治研究 • 上一篇    下一篇

2016—2020年安徽省南陵县新发晚期血吸虫病病例调查分析

邓玉军，闵修春，王静，章大为   

  1. 南陵县疾病预防控制中心，安徽 芜湖 242400
  • 收稿日期:2021-09-07 出版日期:2022-02-20 发布日期:2022-03-02
  • 作者简介:邓玉军，男，大专，副主任医师，研究方向：地方病防治。E-mail：nlfz2005@163.com

Investigation and analysis of newly discovered advanced schistosomiasis cases in Nanling County, Anhui Province from 2016 to 2020

DENG Yu-jun, MIN Xiu-chun, WANG Jing, ZHANG Da-wei   

  1. Nanling County Center for Disease Control and Prevention, Wuhu 242400, Anhui Province, China
  • Received:2021-09-07 Online:2022-02-20 Published:2022-03-02

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摘要： 目的    了解南陵县新发晚期血吸虫病（简称晚血）病例流行病学及临床特征，为制定科学的预防干预措施提供依据。方法    收集并分析2016—2020年南陵县新发晚血病例的基本情况、住院病历资料、影像学和实验室检查结果。结果    2016—2020年南陵县新发晚血共49例，分布于4个乡镇，其中弋江镇34例、籍山镇13例、许镇镇和家发镇各1例。49例新发晚血患者平均年龄为（59.11±11.66）岁，男性26人、女性23人。职业分布上，农民22人，民工17人，家务及待业8人。临床分型上，巨脾型31例，腹水型16例，结肠增殖型2例。首次诊断为血吸虫病到首次确诊为晚期血吸虫病平均历时19.2年，治疗次数平均为4.22次。B超结果显示，49例新发晚血患者中脾肿大31例，脾切除14例，脾正常4例。脾肿大患者血小板和白细胞计数均明显低于脾切除患者，差异有统计学意义（t=-5.552、-4.958，P均<0.05）。49例患者中有乙型或（和）丙型肝炎病毒感染史27例。其中，有乙肝感染史24例，有丙肝感染史6例。有乙型和（或）丙型肝炎感染史的晚血患者白蛋白低于无感染史的患者，差异有统计学意义（t=2.702，P<0.05）。结论    在血防重点地区，应加强对重点人群晚期血吸虫病的线索调查，及时发现晚血病例，并早期进行抗纤维化治疗，减缓晚血病程，同时预防肝炎或抗肝炎治疗。

关键词: 晚期血吸虫病, 肝纤维化, 脾切除, 合并肝炎

Abstract: Objective    To understand the epidemic and clinical characteristics of newly discovered advanced schistosomiasis for evidence to formulate scientific measures against this entity. Methods     The data, including the basic information, inpatient medical records, imaging and laboratory findings were collected from and analyzed in the newly discovered advanced schistosomiasis cases reported in Nanling County from 2016 to 2020. Results     Totally, 49 new cases of advanced schistosomiasis were found in Nanling County between 2016 and 2020, distributed in 4 townships, including 34 cases in Yijiang Town, 13 in Jishan Town, 1 in Xuzhen Town and another 1 in Jiafa Town. Average age of the 49 patients was (59.11±11.66) years. Twenty-six of them were males, and 23 females. The occupations were associated with farmers in 22, migrant workers in 17 and domestic workers in 8. By clinical typing, 31 cases were of splenomegaly, 16 of ascites and 2 of colonic proliferation. The average time was 19.2 years from the initial diagnosis to the first conclusion of advanced schistosomiasis, and the average treatment session was 4.22. B-ultrasound revealed that splenomegaly occurred in 31 of the 49 cases of the advanced schistosomiasis. Fourteen patients underwent splenectomy, and 4 were of normal spleen. The mean count of platelets and leukocytes was significantly lower in patients with splenomegaly than in those undergone splenectomy(t =[-]5.552,[-]4.958; both P<0.05). In the 49 patients, 27 had a history of type B or/and C infection. Twenty four had history of hepatitis B infection, 6 had history of hepatitis C infection. Serum albumin level was significantly lower in patients with hepatitis B and/or C infection history than those without infection history (t=2.702, P<0.05). Conclusion     Survey on the advanced schistosomiasis should be strengthened in the key population living in the crucial areas of schistosomiasis control so that the potential advanced infection can be timely identified and undergone anti-fibrosis therapy in early stage to slow down the disease progression. Additionally, prevention or anti hepatitis treatment is recommended.

Key words: Advanced schistosomiasis, Hepatic fibrosis, Splenectomy, Combined hepatitis