华支睾吸虫病流行区胆石症患者胆囊结石类型及华支睾吸虫感染情况

发布时间：2018-01-31 23:57

本文关键词： 胆囊结石碳酸钙结石华支睾吸虫扫描电镜　出处：《中国寄生虫学与寄生虫病杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的探讨华支睾吸虫病流行区胆石症患者胆囊结石类型与华支睾吸虫感染的关系。方法选取2009年5月至2012年10月在广州市南沙区第六人民医院普外科实施内镜微创取石保胆手术的胆石症患者598例。胆石样品以红外光谱法分析结石成分,判断结石类型。胆石研碎后用光镜检查华支睾吸虫虫卵,计算不同类型结石的虫卵检出率。比较不同类型的结石患者,以及碳酸钙类结石患者中华支睾吸虫虫卵阳性和阴性患者的临床特点和生化特征。选取部分虫卵阳性的碳酸钙类结石行扫描电镜观察。结果 598例胆囊结石患者中,234例(39.1%)为胆固醇类结石,133例(22.2%)为胆色素类结石,112例(18.7%)为碳酸钙类结石,86例(14.4%)为混合类结石,33例(5.5%)为其他类结石。5类胆结石华支睾吸虫卵检出率分别为6.4%(15/234)、44.3%(59/133)、59.8%(67/112)、36.0%(31/86)和30.0%(10/33)。碳酸钙类结石的虫卵检出率最高,胆固醇类结石的虫卵检出率最低。碳酸钙类结石和混合类结石患者的血清CO2结合力高于胆固醇类结石患者(P0.05),碳酸钙类结石患者胆汁CO2结合力和p H值高于其他4组结石患者(P0.05)。碳酸钙类结石患者中华支睾吸虫虫卵阳性者的血清CO2结合力、胆汁CO2结合力和p H值均高于虫卵阴性者(P0.05)。光镜和扫描电镜观察均发现,碳酸钙类结石华支睾吸虫卵与碳酸钙结晶相互黏附。结论碳酸钙类胆囊结石患者的华支睾吸虫感染率高于其他结石类型的患者。
[Abstract]:Objective to investigate the relationship between gallstone types and clonorchiasis infection in cholelithiasis patients in endemic areas of clonorchiasis sinensis. A total of 598 patients with cholelithiasis underwent endoscopic minimally invasive cholecystectomy. The gallstone components were analyzed by infrared spectroscopy. To determine the type of stone. The egg of Clonorchis sinensis was examined by light microscope after the gallstone was grinded. The detection rate of eggs of different types of stone was calculated and the patients with different types of stone were compared. The clinical and biochemical characteristics of positive and negative eggs of Clonorchis sinensis in patients with calcium carbonate calculi were also discussed. Scanning electron microscope was used to observe some positive calcium carbonate stones. 598 patients with gallstone. 234 cases (39. 1) cholesterol calculus 133 cases 22. 2) gallbladder pigment calculus 112 cases (18. 7) calcium carbonate calculi. 86 cases (14.4): 33 cases with mixed calculus (5.5%). The detection rate of egg aspiration in the Chinese epididymis of other class .5 gallstones was 6.410 / 234). The detection rate of calcium carbonate stones was the highest for calcium carbonate calculi (67 / 112 / 360) and 30.0% / 33 / 33 (59.8%) and 30.0% / 10 / 33% (P < 0.05). The detection rate of egg in cholesterol calculi was the lowest. The serum CO2 binding ability of calcium carbonate stone and mixed stone patients was higher than that of cholesterol stone patients (P 0.05). The value of bile CO2 binding ability and pH in calcium carbonate stone patients was higher than that in other four groups (P 0.05). The serum CO2 binding ability of patients with calcium carbonate calculus was positive. The value of bile CO2 binding ability and pH were higher than those of negative eggs (P 0.05). Light microscopy and scanning electron microscopy (SEM) showed that the bile CO2 binding power and pH value were higher than those of negative eggs. Conclusion the infection rate of Clonorchis sinensis in patients with calcium carbonate gallstone is higher than that in patients with other types of stones.
【作者单位】：广州市南沙区第六人民医院;广州市番禺区第二人民医院;
【分类号】：R532.23
【正文快照】： *Corresponding author,E-mail:olive5327@163.com胆囊结石早在3 500年前古埃及木乃伊和2 000年前长沙西汉女尸内就已被发现[1],目前仍是世界范围内一种严重困扰人类健康的常见病,其发病率在西方国家为10%~20%[2]。在中国,胆囊结石的发病率逐年上升,已由2%~7%升至目前的12.1%[

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