171例华支睾吸虫病患者临床资料分析

Clinical analysis on 171 cases of clonorchiasis

目的了解171例华支睾吸虫病病例的临床特征。方法对确诊的华支睾吸虫病患者的临床资料、实验室和B超影像学检查及再感染情况等进行描述分析。结果 171例患者多数无明显症状或仅有轻度乏力、肝区不适等症状,病情较轻,其中无不适症状者占58.33%(99/171),出现乏力、食欲减退者占42.11%(72/171);肝功能异常发生率为57.31%(98/171);122例进行了B超检查,发现合并胆囊炎8例,胆囊结石3例,肝内胆管回声增强35例,肝内胆管回声增强并肝内胆管轻度扩张42例,脂肪肝10例;再感染发生率高,24例经吡喹酮后,有22例华支睾吸虫虫卵和/或华支睾吸虫抗体阳性;再感染者中肝内胆管轻度扩张发生率为68.18%(15/22),未经治疗患者发生率为27.55%(27/98),差异有统计学意义(χ2=10.43,P<0.01)。结论华支睾吸虫病多数患者无明显症状或仅有轻度乏力、肝区不适等症状,病情轻;再感染发生率高,且肝内胆管扩张发生率较高。

Objective To investigate the features of 171 of cases of clonorchiasis.Methods Descriptive analysis was performed on 171 cases of confirmed clonorchiasis from October 2005-December 2006 based on clinical data,laboratory tests,and a B ultrasound examination.The prevalence of reinfection was also analyzed.Results Most patients in the 171 cases were asymptomatic or only had mild fatigue and liver discomfort.Of the patients,58.33%（99/171） had no discomfort 58.33% while 42.11%（72/171） had fatigue and a loss of appetite.Abnormal liver function was noted in 57.31%（98/171） of patients.Of the 171 patients,122 underwent a B ultrasound;this examination revealed accompanying cholecystitis in 8 patients,gallbladder stones in 3,a hypoechoic intrahepatic bile duct in 35,a hypoechoic intrahepatic bile duct and slightly dilated intrahepatic bile duct in 42,and a fatty liver in 10.There was a high incidence of re-infection.After 24 patients were treated with praziquantel,22 tested positive for Clonorchis eggs or antibodies.Mild dilation of the intrahepatic bile ducts of the liver occurred at a rate of 68.18%（15/22） while the rate it occurred in untreated patients was 27.55%（27/98）.The difference was statistically significant（X2 = 10.43,P 〈0.01）.Conclusion Most patients with clonorchiasis have no obvious symptoms or only mild fatigue,liver discomfort,or other symptoms.Clonorchiasis is slightly prevalent,it has a high incidence of re-infection,and it has a high incidence of dilation of the intrahepatic bile ducts.