开平市华支睾吸虫病调查与防治研究

Survey and Control Measures on Clonorchis sinensis in Kaiping City

目的为了解开平市华支睾吸虫感染状况,探索大规模调查华支睾吸虫病流行病学的诊断技术和防治措施。方法采用改良加藤氏厚涂片法粪检和ELISA法血检水口镇东方红村和黎村人群华支睾吸虫卵和抗体。华支睾吸虫感染患者作腹部B超检查及服用阿苯哒唑驱虫糖。开展中间宿主和保虫宿主调查。结果华支睾吸虫总感染率为34.1%。其中东方红人群感染率34.8%,黎村感染率33.3%。男、女性感染率分别为44.4%和26.8%。以15～60岁年龄组最高。虫卵密度EPG平均值男、女性分别为200.2和164.8,多属轻度感染。酶标检测感染率36.0%,与粪检的34.1%无显著性差异。服用阿苯哒唑驱虫糖后虫卵阴转率为95.5%。在当地鱼塘的鱼苗中找到华支睾吸虫囊蚴,解剖当地犬和猫发现有华支睾吸虫成虫。结论开平市已是华支睾吸虫流行区之一,酶标检测可做为大规模流行病学调查。阿苯哒唑驱虫糖可有效防治华支睾吸虫感染。

Objective To study the epidemic status of Clonorchis sinensis infection in Kaiping city, and establish a diagnostic method for large scale of epidemiology investigation for Clonorchis sinensis. To set up effective control and prevention measures. Methods Clonorchis sinensis eggs in stool samples were detected by Kato Katy thick smear methods and Clonorchis sinensis specific antibodies of blood samples were detected by ELISA. Clonorchis sinensis infected individuals were also diagnosed with abdominal ultrasound scanning and treated with albendazole anti helminthes sweeties. And the investigation to intermediate and reservoir hosts had also been carried out. Results The total infection rate of Clonorchis sinensis in the local area was 34.1%. The infection rates of Dongfenghong village and Licun village were 34.8%and 33.3%, respectively. And the infection rates of male and female were 44.0%and 26.8%, respectively. The infection rate of 15～60 age group was higher than other age groups. The averge EPG of male and female were 200.2 and 164.8, respectively. The condition of 99.0%(374/377) infected individuals were mild. None showed hepatic and bile duct pathological changes. There was no significant difference in the infection rate determined by Kato Katy and ELISA methods. The negative conversion rate of 226 persons was 96.0%after albendazole anti helminthes sweeties therapy. Clonorchis sinensis larval was discovered in the fry of the local fish pools. Clonorchis sinensis imago was found in the local dogs and cats in the autopsy. Conclusions Clonorchis sinensis was endemic in the two villages of Kaiping city. ELISA diagnosis could replaced fecal examination in the large scale of epidemiology investigation for Clonorchis sinensis. Albendazole anti helminthes sweeties therapy could significantly controlled the infection of Clonorchis sinensis.