云南省宾川县大片形吸虫病四例临床分析

Clinical analysis of 4 cases of Fasciola gigantica infection from Binchuan County, Yunnan Province

目的探讨大片形吸虫感染的流行病学特点、临床表现、诊断和治疗方法，为大片形吸虫病的诊治提供参考。方法回顾性分析4例确诊为大片形吸虫病患者的流行病学资料、临床表现、实验室检查结果、影像学表现、诊断和治疗转归情况。结果4例大片形吸虫病患者均为云南省大理州宾川县农民，均表现为发热、肝区疼痛和叩痛、肝脏肿大、嗜酸粒细胞增多、球蛋白升高、血WBC和中性粒细胞升高、不同程度的贫血，肝脏CT扫描均提示肝实质内散在多发低密度影，粪便检出大片形吸虫卵，ELISA检测大片形吸虫抗体均阳性，三氯苯达唑治疗效果显著。结论人体感染大片形吸虫少见，无特异性临床表现，三氯苯达唑是治疗的首选药物。

Objective To explore the epidemiological characteristics, clinical manifestations, diagnosis and treatment of Fasciola gigantica infection, and to provide reference for future diagnosis and treatment. Methods Four cases of confirmed Fasciola gigantica infection were analyzed retrospectively for epidemiological information, clinical manifestations, laboratory results, imaging findings, diagnosis and treatment outcomes. Results Four Fasciola gigantica infection cases were farmers from Binchuan County, Yunnan Province. All presented with fever, hepatalgia, percussion pain, hepatomegaly, eosinophilia, hyperglobulinemia, neutrophilia and anemia. Computed tomography （CT） scans showed multiple low density shadows scattered in the liver parenchyma. Eggs of Fasciola gigantica were detected in feces of the patients, and results of antibody against Fasciola gigantica detected by enzyme-linked immunosorbent assay （ELISA） were positive. Triclabendazole treatment was effective. Conclusion Human Fasciola gigantica infection is rare, without specific clinical manifestations, and triclabendazole is the first choice of treatment.