腹泻患者粉螨感染调查

Investigation on the relationship between diarrhea and acarid mites

目的探讨粉螨致腹泻的发生特点。方法对腹泻患者进行粪螨分离、皮肤挑刺试验、血清总IgE、螨特异性IgE检测。其中粪螨分离采用饱和盐水漂浮法,抗体检测使用ELISA法。结果共检查241例腹泻患者,粪螨阳性率为17.01%(41/241),男、女粪螨阳性率分别为15.86%(23/145)和18.75%(18/96),差异无显著性(χ2=0.34,P>0.05);皮肤挑刺试验""、""、"+"、"±"和"?"者分别占9.13%(22/241)、7.47%(18/241)、5.81%(14/241)、4.98%(12/241)和72.61%(175/241)。粪螨阳性和阴性腹泻患者血清总IgE、螨特异性IgE分别为(165.72±78.55)IU/ml、(132.44±26.80)IU/ml和(145.22±82.47)IU/ml、(67.35±45.28)IU/ml,差异均具显著性(P<0.01)。从事中药材、粮食储藏和加工者粪螨阳性率为26.74%(23/86),其他职业人群粪螨阳性率为11.61%(18/155),差异具显著性(χ2=8.97,P<0.01)。结论粉螨寄生人体肠道可导致粉螨性腹泻,并使患者血清总IgE、螨特异性IgE升高,粉螨浸液皮肤挑刺试验阳性。腹泻患者粉螨感染的发生与所从事的职业有一定关系,但与性别无关。

Objective To study the characteristics of acarid-related diarrhea. Methods Separation of mites from stool samples, skin prick test and detection of total IgE and specific IgE for mites were carried out in patients with diarrhea. Saturated saline flotation methods were served in separation of mites from stool samples and ELISA was served in antibody detection. Results A total of 241 patients with diarrhea were involved in this study. Mites were detected in stool samples of 17.01% of all the 241 subjects, 15.86% （23/145） in male patients and 18.75% （18/96） female patient, and there was no significant difference between them. The results of skin prick test showed that the percentages of ＂＋＋＋＂, ＂＋＋＂, ＂＋＂,＂±＂ and ＂-＂were 9.13% （22/241）, 7.47% （18/241）, 5.81% （14/241）, 4.98% （12/241） and 72.61% （175/241） respectively. The levels of total IgE, specific IgE in serum of patients with and without mites in stool samples were （165.72±78.55） IU/ml, （132.44±26.80） IU/ml and （145.22±82.47） IU/ml, （67.35±45.28） IU/ml respectively, and there were significant difference between them （P〈0.01）. Mites were detected in 26. 74% （23/86） stool samples taken from staffs working in traditional Chinese medical storehouses or rice storehouses, and 11.61% （18/155） stool samples taken from patients with other occupations, and they were significantly different （χ2 = 8.97, P〈0.01）. Conclusion It is suggested that Acarld could cause acarid-related diarrhea, and patients with acarid-related diarrhea are with positive results in skin prick test and higher levels of total IgE and specific IgE for mites. It seems that the preva- lence of acarid-related diarrhea is associated with occupations of the patients, but not with gender.