Human cases of simultaneous echinococcosis and tuberculosis - significance and extent in China
Human cases of simultaneous echinococcosis and tuberculosis - significance and extent in China
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DOI：
10.1186/1756-3305-2-53
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发表时间：
2009-11-04
影响因子：
3.2
通讯作者：
McManus, Donald P.
中科院分区：
文献类型：
--
作者：
Yang, Yu Rong;Gray, Darren J.;McManus, Donald P.
在回顾社区调查资料的分析过程中，我们在宁夏南部回族自治区西吉县发现了两名同时患有包虫病和结核病的患者，这是中国的首次报告。随着包虫病慢性化程度的增加，两个受试者的免疫状况从Th1反应转变为Th2反应，正如结核病皮肤试验所显示的那样，最初呈阳性，后来变为阴性。Th2免疫水平升高，随后Th1免疫反应受到抑制，这是慢性蠕虫感染的常见特征。考虑到确定诊断的困难，以及晚期包虫病患者对结核病感染的潜在易感性，我们建议未来在这一领域进行结核病/包虫病联合调查。这将使结核病和包虫病得到早期诊断，并获得更好的预后，从而获得有效和可持续的治疗结果，最终减少相关的发病率和死亡率，并降低中国这一欠发达地区个人和公共卫生保健系统的总体财务成本。
During analysis of retrospective community survey data, we identified two patients from Xiji County, south Ningxia Hui Autonomous Region with simultaneous echinococcosis and tuberculosis (TB), representing the first such reports for China. As the echinococcosis chronicity increased, the immune profile in both subjects changed from a Th1 to Th2 response, as shown by a TB skin test, originally positive, becoming negative. Such an elevated Th2 immune profile, with subsequent suppression of the Th1 immune response, is a common feature of chronic helminth infections. Given the difficulties in definitive diagnosis, and the potential increased susceptibility for TB infection in patients with advanced echinococcosis, we suggest that combined TB/echinococcosis surveys be undertaken in this area in the future. This would allow early diagnosis of both TB and echinococcosis cases with better prognosis for effective and sustainable treatment outcomes, ultimately reducing associated morbidity and mortality, and also the overall financial costs to the individual and the public health care system in this under developed part of China.