肺吸虫病诊治的研究

摘要目的提高肺吸虫病的临床诊治水平。方法对18例肺吸虫病患者的资料进行全面的统计、分析。结果所有患者发病前均有生食水产品史。15例患者的末梢血嗜酸细胞百分比以及绝对计数升高（占83。3%），6例患者抽取胸水检测，其嗜酸细胞百分比均升高到29%~85%。此病的肺吸虫皮内试验及血清肺吸虫循环抗体检测敏感性虽高，但特异性较差。而血清吸虫循环抗原特异性相对较高，同时对治疗亦有指导作用。经吡喹酮治疗后，所有患者均康复出院。结论肺吸虫患者均有生食水产品史，临床表现多样，末梢血及胸水中嗜酸细胞计数和血清肺吸虫循环抗原、抗体检测有助于此病的诊断，吡喹酮仍是治疗此病的有效药物。

关键词肺吸虫病诊断治疗

DiagnosisandTreatmentofParagonimiasisAbstract:ObjectiveToenhancethelevelofthediagnosisandtreatmentofparagonimiasis.MethodsRetrospectivecaseserieswerestudied.ResultsAll18casesofparaonimasispatientshadeatenrawaquaticproductbeforethediseaseoccurred.Clinicalmanifestationswerevaried.Pleurorrhea,cough,expectoration,feverandchestpainwerecommon（88.95%,83.3%,61.6%and50%）.Somecasesofunknownpneumatothorax（22.2%）wererelatedtoparagonimiasis.Loboratoryexamination:therisingofpercentageandabsolutecountofeosinolphilicgranulocyteinperipheralbloodwasoneofthecharacteristics（83.3%）.Sixcaseswithhydrothoraxshowedthateosinophilicgranulocytewas29%~85%inpleurorrhea.Althoughthesensitivityofintradermalreactionanddetectionofthecirculatingantibodyinserumofparagonimiasiswashigh,thisspecificitywasrelativelypoor.Thespecificityofthecirculatingantigenofparagonimiasisinserumwasrelativelyhighandthiscirculatingantigenplayedaguidingroleintreatmeng.Praziquantelisstillasafeandeffectivemedicineintreatingparagonimiasis.ConclucionThepatientsofparagonimiasishavehistoryofeatingrawequaticproduct,clinicalmanifestationsisvaried.Thecountofeosinophilicgranulocyteinperipheralbloodandpleurorrheaandthedetectionofthecirculatingantibodyandantigeninserumplayanimportantroleindiagnosis.Praziquantelisaneffectivemedicineintreatingthisdisease.

KeywordsParagonimiasisDiagnosisTreatment