家猫华支睾吸虫感染状况与肝胆管病变观察

Clonorchis sinensis infection situation and hepatobiliary duct lesion observation in domestic cats

目的了解广州市郊区家猫感染华支睾吸虫的现状,探讨家猫感染现状与肝胆管组织病理变化的关系。方法收集家猫,取猫肝检查,获取自然感染华支睾吸虫的阳性猫肝,观察猫肝病变,收集成虫。实验共收集到家猫肝胆组织1283个,取肝胆管组织制作石蜡切片,经三色染色后,观察组织切片病变特点。结果本次检查的家猫华支睾吸虫自然感染率为33.59%(431/1283)。从感染成虫数及肝小叶纤维化程度对感染程度进行划分,感染虫数在20条以下属轻度感染猫肝,胆总管略有肿胀,二级胆管稍粗;感染虫数在21~100条之间属中度感染猫肝,胆囊膨胀,总胆管明显肿胀,二级胆管明显增粗;感染虫数在100条以上属重度感染猫肝,胆囊极度膨胀,胆囊壁变薄,二级胆管明显增粗,可见三级胆管增粗。猫肝胆管组织病理切片显示:轻度感染者肝小叶门管区可见组织纤维化,门管区域内出现淋巴样白细胞浸润;中度感染者门管区严重病变,门管区胆管上皮层组织增生,形成胆管腺瘤样增生的病理变化特征;重度感染者肝小叶坏死后形成组织纤维化区域,区域内可见众多的空白小腔,淋巴样白细胞浸润。结论广州市郊区家猫华支睾吸虫自然感染率仍然较高;成虫早期寄生在二级胆管的门管区,引起胆管扩张和管周纤维化及胆管组织腺瘤样形成;随着病程的发展,病变延伸至三级胆管和末梢胆管。从门管区域的病变观察中发现静脉腔的扩张更为严重,从而使得病变重心向肝小叶发展,病变进一步发展使整个肝小叶形成纤维化。

Objective To investigate the status of Clonorchis sinensis infection in wild domestic cats in Guangzhou suburbs,and explore the correlation between the infection status of domestic cats and the pathological changes of hepatobiliary ducts.Methods The Clonorchis sinensis positive livers were gathered from the infected domestic cats.The hepatobiliary duct lesions were observed and the Clonorchis sinensis adults were collected.The lesion characteristics of hepatobiliary duct histological section were observed via HE staining and masson staining.Results The natural infection rate of Clonorchis sinensis in domestic cats was 33.59%(431/1283).The infection degree of domestic cats was divided into three levels:mild,moderate and severe.The infected cats with less than 20 worms were mildly infected with cat liver,slight swelling of common bile duct and slightly thick of secondary bile duct;those infected with 21-100 worms were moderately infected with cat liver,gallbladder distention,common bile duct swelling,secondary bile duct thickening;and those with more than 100 infected worms were classified as severely infected cat liver,the gallbladder is extremely dilated,the gallbladder wall becomes thinner,and the secondary bile duct is obviously thickened,and the tertiary bile duct is visible.Pathological sections of liver and biliary duct tissue of cats mildly infected with Clonorchis sinensis showed fibrosis in the portal duct area of liver lobules and lymphoid leukocytes infiltration in the portal duct area;moderate infection of Clonorchis sinensis showed severe pathological changes in the portal duct area,hyperplasia of the upper cortex of the bile duct in the portal duct area,and the pathological features of adenomatous hyperplasia of the bile duct;severely infected with Clonorchis sinensis showed areas of tissue fibrosis after necrosis of liver lobules,numerous blank small lumens,and lymphoid leukocytes infiltration in these areas.Conclusions The infection rate of Clonorchis sinensis in wild domestic cats in Guangzhou suburbs was still high.Prominent hepatobiliary duct lesions were observed in positive domestic cats and mainly occurred in the portal area of the secondary bile duct.The bile duct lumen,venous cavity and arterial lumen of the portal area significantly widened.The scope of fibrosis expanded and spread to the peripheral and central venous areas with the development of the disease.