马来丝虫病急性淋巴管、淋巴结炎反复发作的研究

STUDIES ON THE RECURRENT ATTACKS OF ACUTE ADENOLYMPHANGITIS DUE TO MALAYAN FILARIASIS

[目的 ]阐明丝虫与细菌感染对马来丝虫病急性淋巴管、淋巴结炎反复发作的作用。 [方法 ]1逐月访视病人 ,观察急性炎症发作季节消长。2在急性期患者的炎症部位取样作细菌培养 ;在急性发作过后不同时期作血清抗链球菌溶血素‘O’效价测定。3采取有效控制丝虫病传播或乙胺嗪治疗急性炎症史患者 ,观察急性发作的变化。 [结果 ]1发现急性发作高峰与蚊媒传播季节高峰相一致。2在急性发作患者中 ,97例作细菌培养 ,90例为阴性 ;2 5 5例作抗‘O’效价测定 ,初次发作和单纯炎症患者 94.1% (143/ 15 2 )未见效价增高。3在丝虫病传播得到有效控制后 ,急性炎症年发作率 ,初发和单纯炎症史患者迅速显著下降。4仅对急性炎症史者采取抗丝虫成虫治疗未能证实其减少炎症发作的效果。 [结论 ]在马来丝虫病流行区 ,急性淋巴管、淋巴结炎反复发作的主要原因是 ,丝虫病传播存在 ,患者受到重复感染 ,由感染期幼虫侵入人体后激发所致。

Objective] To explore the role of filarial and bacterial infections in the recurrent attacks of acute adenolymphangitis due to malayan fialriasis. [Methods] 1. To observe the seasonal fluctuation of acute attacks by performing monthly follow\|up on patients with history of acute attacks in recent years. 2. To study the relationship between bacterial infection and filarial adenolymphangitis by performing bacteria culture and anti\|streptolysin O test. 3. To investigate the variation of acute attacks by controlling filariasis transmission or by treating patients with a history of recurrent acute attacks. [Results] 1. The peak of acute attacks in patients coincided with the peak of vector transmission season. 2. Of the 97 cases examined by bacteria culture, 90 cases were negative; of the 255 cases examined by anti\|streptolysin O test, the titres in 94\^1%(143/152) of the cases with first attack and simple adenolymphangitis were within normal limits, however, the titres in 27\^2%(28/103) of the cases complicated with elephantiasis were increased. 3. The acute attack rate of adenolymphangitis per year reduced significantly in cases with first attack and simple adenolymphangitis after effective control of filariasis transmission. 4. There was no evidence of the reduction of acute attacks by treating patients with DEC alone. [Conclusion] In malayan filariasis endemic areas, the main causes of recurrent attacks of acute adenolymphangitis might be the repeated filarial infections due to the persistence of filariasis transmission.