浙江省首例本地感染牛带绦虫的诊断和治疗

Diagnosis and treatment of a local case of Taenia saginata infection in Zhejiang Province

目的对浙江省1例本地感染绦虫病例进行诊断和治疗,并确定其所感染绦虫的种类。方法收集患者发病、临床表现、诊治过程等信息,对患者开展流行学调查。采用肛周透明胶纸法检查虫卵。使用槟榔-南瓜子进行驱虫治疗,对患者排出的虫体进行形态学观察,采用PCR扩增虫体DNA的线粒体细胞色素C氧化酶1(cytochrome C oxidase 1,COX1)基因片段并进行序列分析。结果流行病学调查结果显示,患者近两年无县外出行史,无食生猪肉、牛肉或动物内脏史,但经常食用烧烤肉类及火锅,偶尔食用生蔬菜。患者肛周皮肤检查发现带绦虫虫卵。患者排出的虫体经形态学观察疑似为牛带绦虫(Taenia saginata)或亚洲带绦虫(Taenia asiatica)。PCR扩增COX1基因片段获得832 bp扩增产物,测序后经Bl AST比对分析显示,与牛带绦虫COX1基因(Gen Bank登录号为AB107239.1)序列相似性为99%,而与亚洲带绦虫(Gen Bank登录号为AB107235.1)和猪带绦虫(Taenia solium,Gen Bank登录号为AB066485.1)COX1基因序列相似性分别为96%和88%。结论综合患者的临床特征、流行病学信息和排出虫体的序列分析结果 ,确认该病例为本地感染牛带绦虫病例。

Objective To diagnose and provide treatment for a local case of taenia infection in Zhejiang Province and identify the species of the worm. Methods The information of disease onset, clinical feature and therapeutic process was collected and epidemiological investigation was carried out. The anal cellophane swab was used to detect the eggs. Areca and pumpkin seeds were used for deworming. Morphological observation, PCR amplification and sequencing of cytochrome C oxidase 1（COX1） gene were performed for the discharged worm. Results The epidemiological results showed that the patient did not go outside Pujiang County in the past two years, and had no history of eating raw pork, beef or animal offal. But she often had barbecues and hot-pot food, occasionally with raw vegetables. Taenia eggs were found on her perianal skin. The discharged worm was suspected to be Taenia saginata or Taenia asiatica by morphological observation. PCR amplification of COX1 resulted in a band of 832 bp, which was 99%, 96% and 88% homologous to COX1 of Taenia saginata （GenBank accession number： AB107239.1）, Taenia asiatica（GenBank accession number： AB107235.1） and Taenia solium（GenBank accession number： AB066485.1）, respectively. Conclusion According to the clinical feature, epidemiological information and sequencing results, this case is confirmed to be a local infection of Taenia saginata.