肺吸蟲、曼氏絳蟲、帶絳蟲、細粒棘球絳蟲鄒課件

Paragonimuswestermani

ParagonimuswesternaniwasfirstdescribedfromtwoBengaltigerthathaddiedinzoosinEuropein1878.Duringthenext2years,infectionsbythisworminhumanswerefoundinFurmosa.Itwasveryquicklyfoundinthelungs,brain,andvisceraofhumansinJapan,Korea,andthePhilippines.ThelifecyclewasworkedoutbyKobayashiandYokagawa.ThemajorfocusofinfectiontodayremainsintheOrient,includingIndiaandthePhilippines.ItalsoappearstobeendemicthroughouttheEastIndies,NewGuinea,theSolomonIslands,Samoa,westernAfrica,Peru,Colombia,andVenezuela.Thetaxonomyofthegenusisdifficult,andsomeofthesereportsmaybeofother,closelyrelatedspecies.Paragonimiasisisanexcellentexampleofzoonosis.

并殖吸蟲Paragonimuswestermani衛(wèi)氏并殖吸蟲Pagumogonimusskrjabini

斯氏貍殖吸蟲人獸共患型獸主人次型衛(wèi)氏并殖吸蟲（肺吸蟲）Paragonimuswestermani卵巢子宮睪丸卵黃腺一、形態(tài)成蟲卵黃腺腸支口吸盤睪丸腹吸盤子宮毛蚴胞蚴川卷螺成蟲（肺）人、犬、貓、虎等

囊蚴入水（痰、糞便）體內(nèi)移行穿腸壁肺穿膈肌胸腔腹腔二、生活史Lifecycle母雷蚴子雷蚴尾蚴溪蟹滯育童蟲

（野豬、野鼠）卵竄擾肝、腦、皮下1、感染期：2、感染方式：3、寄生部位：4、終宿主：5、保蟲宿主：囊蚴生吃含囊蚴的溪蟹、轉(zhuǎn)續(xù)宿主的肉（豬肉）犬、貓、虎人生活史特點：肺、異位寄生三、致?。╬athogenesis)急性期慢性期膿腫期囊腫期纖維疤痕期Theearly,invasionstagesofparagonimiasiscausefewornosymptomaticpathologicalconditions.Onceinalungoranectopicsite,thewormstimulatesconnectivetissueproliferationthateventuallywillenshrouditinabrownishorbluishcapsule.Suchcapsulesoftenulcerateandhealslowly.Eggsinsurroundingtissueswillthemselvesbecomecentersofpseudotubercles.Wormsinthespinalcordareknowntocauseparalysis,whichsometimesistotal.FatalcasesofParagonimusinthehearthavebeenrecorded.Cerebralcaseshavethesameresultsasthoseofcerebralcysticercosis.Pulmonarycasesusuallycausechestsymptoms,withbreathingdifficulties,chroniccough,andsputumcontainingbloodorbrownishstreaks.Fatalcasesarecommon.三、致?。╬athogenesis)臨床分型胸肺型腹型皮下包塊型腦脊髓型亞臨床型其他型四、診斷（diagnosis)病原學(xué)診斷免疫學(xué)診斷痰檢蟲卵活組織檢查糞檢蟲卵ELISA酶聯(lián)免疫吸附試驗皮內(nèi)試驗直接涂片法五、流行與防治

(EndemityandPrevention)流行毛蚴胞蚴川卷螺成蟲（肺）人、犬、貓、虎等

囊蚴入水（痰、糞便）母雷蚴子雷蚴尾蚴溪蟹滯育童蟲

（野豬、野鼠）卵123傳染源卵巢子宮睪丸卵黃腺一、形態(tài)成蟲斯氏貍殖吸蟲Pagumogonimusskrjabini第十一章

絳蟲(Cestode)第一節(jié)概論P131肥胖帶絳蟲幼節(jié)成節(jié)孕節(jié)頭節(jié)圓葉目假葉目豬帶絳蟲牛帶絳蟲曼氏迭宮絳蟲四個吸盤二個吸槽有生殖孔、無子宮孔有生殖孔和子宮孔只有子宮，其余退化與成節(jié)結(jié)構(gòu)相似頭節(jié)：成節(jié)：孕節(jié)：CyclophyllideaPseudophyllidea前進圓葉目頭節(jié)假葉目頭節(jié)吸盤吸槽圓葉目成節(jié)假葉目成節(jié)圓葉目孕節(jié)假葉目孕節(jié)(曼氏迭宮絳蟲)SpirometramansoniadultMorphologyP123About60-100centimeterAbout100proglottidsScolexofSpirometramansoni:finger-shapedwitheachbothriumonthedorsalandventralsurface.bothriumplerocercoid(裂頭蚴)鉤球蚴隨糞入水成蟲（小腸）貓、犬、人卵原尾蚴

人、蛇、鳥、豬食入裂頭蚴裂頭蚴（蛙）劍水蚤蝌蚪、人Lifecycle眼裂頭蚴病皮下裂頭蚴病腦裂頭蚴病內(nèi)臟裂頭蚴病Adultwormsoccasionallyresideinhumans.Pathogenesis活組織檢查免疫學(xué)診斷CT、磁共振等DiagnosisofsparganosisEpidemiologysourceofinfectionsusceptiblepopulationmodeoftransmission局部貼生蛙肉生食或半生食蛙、蛇、雞或豬肉、馬肉飲生水誤食感染的劍水蚤Howinfecthumanssparganosis?吡喹酮手術(shù)摘除Preventionandcontrol肥胖帶絳蟲(Taeniasolium)（Taeniasaginata）豬帶絳蟲牛帶絳蟲鏈狀帶絳蟲p132豬帶絳蟲牛帶絳蟲體長：成節(jié)：2-4米4-8米孕節(jié)：卵巢分三葉卵巢分二葉分支不齊，每側(cè)有7-13支分支整齊，每側(cè)有15-30支頭節(jié)：球形，四個吸盤有頂突、小鉤方形，四個吸盤無頂突、小鉤前進一、形態(tài)成蟲豬帶絳蟲牛帶絳蟲幼節(jié)成節(jié)孕節(jié)頭節(jié)豬帶絳蟲牛帶絳蟲頭節(jié)小鉤吸盤吸盤頭節(jié)豬帶絳蟲成節(jié)牛帶絳蟲成節(jié)3葉2葉豬帶絳蟲孕節(jié)牛帶絳蟲孕節(jié)7-13支15-30支囊尾蚴中等偏小圓球形棕黃色含一個六鉤蚴卵殼很薄，易脫落胚膜呈放射狀條紋大小形狀顏色卵殼內(nèi)容物其他蟲卵胚膜六鉤蚴卵殼六鉤蚴成蟲（小腸）人孕節(jié)(卵)隨血流囊尾蚴（肌肉）

經(jīng)口人誤食六鉤蚴囊尾蚴錄像二、生活史(lifecycle)豬食入六鉤蚴成蟲（小腸）人孕節(jié)(卵)隨血流囊尾蚴（肌肉）

經(jīng)口牛食入InfectivestageDiagnosticstageOncosphereshatch,penetrateintestinalwall,andcirculatetomusculatureOncospheresdevelopintocysticerciinmuscleHumansinfectedbyingestingraworundercookedinfectedmeatEggsorgravidproglottidsinfecesandpassedintoenvironmentScolexattachestointestineAdultsinsmallintestineT.saginataT.soliumCattleandpigsbecomeinfectedbyingestingvegetationcontaminatedbyeggsorgravidproglottids三、致?。╬athogenesis)豬囊尾蚴病成蟲致病豬帶絳蟲病牛帶絳蟲病幼蟲致病（囊蟲?。┳泽w內(nèi)感染自體外感染異體感染人是如何感染豬囊尾蚴病？皮下及肌肉囊尾蚴病腦囊尾蚴病眼囊尾蚴病囊尾蚴病分型錄像帶絳蟲病的診斷查節(jié)片問病史四、診斷（diagnosis)肛門拭子法四、診斷（diagnosis)ELISA酶聯(lián)免疫吸附試驗間接紅細胞凝集試驗IHA斑點酶聯(lián)免疫吸附試驗Dot-ELISA囊尾蚴病的診斷活組織檢查免疫學(xué)檢查CT、磁共振、眼底鏡五、流行(Endemity)傳染源傳播途徑“生皮”“過橋米線”“剁生”易感人群錄像南瓜子＋檳榔吡喹酮、阿苯噠唑六、防治（Preventionandcare)手術(shù)摘除細粒棘球絳蟲（包生絳蟲）

EchinococcusgranulosusMorphology成蟲頭節(jié)幼節(jié)成節(jié)孕節(jié)棘球蚴棘球蚴實物棘球蚴蟲卵：與豬帶、牛帶絳蟲卵基本相同Lifecycle蟲卵棘球蚴

成蟲（犬、食肉動物）血循環(huán)（羊、牛等動物內(nèi)臟）六鉤蚴犬食入人、羊、牛生活史特點：1、終宿主：犬、狼、豺等；2、中間宿主：羊、牛、駱駝、豬、鹿等，偶有馬、人；3、感染方式：誤食入了孕節(jié)或蟲卵；4、棘球蚴在人體內(nèi)主要寄生部位：肝、肺、腹腔、腦等致病1、局部壓迫和刺激癥狀：肝、肺等2、中毒和過敏癥狀包蟲病診斷1、詢問病史2、X線、CT、MRI等3、手術(shù)活檢4、免疫學(xué)試驗：皮試、血清學(xué)檢查流行防治綿羊犬牦牛犬治療：阿苯達唑、手術(shù)預(yù)防為主人獸共患病世界性分布，我國分布于西北、華北等農(nóng)牧區(qū)1、食入未煮熟的豬肉可使人感染的蠕蟲有：A牛帶絳蟲B豬帶絳蟲C曼氏迭宮絳蟲D旋毛蟲√選擇題E肺吸蟲√√√2、下列寄生蟲中可引起人體幼蟲移行癥的有：A十二指腸鉤蟲B蛔蟲C斯氏貍殖吸蟲D日本血吸蟲E曼氏迭宮絳蟲√√3、引起人獸共患寄生蟲病的寄生蟲有：A旋毛蟲B班氏絲蟲C豬囊尾蚴病D華支睪吸蟲√E日本血吸蟲√√√4、哪種寄生蟲人可以成為它的中間宿主和終宿主：A豬帶絳蟲B牛帶絳蟲C