国内人体猪巨吻棘头病的流行病学特征

Epidemic Characteristics of Human Macracanthorhynchus Hirudinaceus in China

目的总结分析国内人体猪巨吻棘头虫病的发病特征与危害,并提出相应防控措施。方法收集整理自1964年国内报道首例人体猪巨吻棘头虫病例以来,多种医学尤其是寄生虫学书籍和杂志等的有关资料,总结分析该病发病状况、感染原因、临床特征、误诊因素等。结果 1964/2012-06,国内人体猪巨吻棘头虫病分布在15个省区中的38个市县,患病248人,均为生食或半生食天牛、金龟等甲虫受染;农村发病人数多于城市;有明确病历资料显示的患者年龄为1.8～53岁,其中14岁以下患儿占82.36%;其中237例有明确性别记录,男性161人,女性76人。发病季节与甲虫的消长季节密切相关,3～11月份为感染季节,7～8月份为高峰。主要临床特征为腹痛,血便或脓血便,肠穿孔,肠坏死;44%的患者手术切除15～150cm坏死肠腔;99.20%的患者(246/248)粪便中未查见该虫的虫卵。结论国内人体猪巨吻棘头虫病有一定的地域性,发病者主要为14岁以下儿童,与生食甲虫有关。

Objective To analyze the epidemic characteristics of human Macracanthorhynchus hirudinaceus （HMH） in China, for purpose of pertinent preventative measures. Methods Domestic HMH data from 1964 to Jun. 2012 from parasite medicine books, monographs, magazines, parasite sci - tech journals, etc. were systematically reviewed and collected. Statistical analysis were carried out on aspects of morbidity situation, clinical symptoms, misdiagnose factors and species of beetles ate by patients. Results The HMH patients distributed in 38 cities and counties of 15 provinces from 1964 to June 2012, and totally 248 people were attacked. Patients were all contaminated after eating raw or half- raw beetles and Scarabaeidae, etc. The patients in rural areas were more than that in cities. The patients ranged from 1. 8 to 53 years old, yet concentrated under 14 years old, accounting for 82. 36%. Males （161） were more than females （76）. The disease mostly was prevalent from March to November, and peaked in July to August. The main clinical features wereabdominal pain, diarrhea, melena, bloody purulent stool, abdominal tenderness, rebound pain, positive FOBT, intestinal perforation and intestinal necrosis. About 44% of total patients were operated excision of 15 - 150 cm necrotic intestine during surgery. Up to 99.20% of the patients failed to be detected with the parasitic eggs in their stool samples. Conclusion The HMH cases are relatively rare in China, and take on areal distribution. The onset of the disease is related with behaviors of eating Scarabaeidae. The high risk population is mainly children under 14 years.