Clonorchiasis: an update
Clonorchiasis: an update
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DOI：
10.1079/joh2005300
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发表时间：
2005-09-01
影响因子：
1.6
通讯作者：
Rim, HJ
中科院分区：
文献类型：
--
作者：
Rim, HJ
华支睾吸虫是一种重要的人类寄生虫，广泛分布于韩国南部、中国(含台湾)、日本、越南北部和俄罗斯远东地区。华支睾吸虫病在世界各地都有发生，那里有来自流行区的亚洲移民。人和动物的宿主(狗、猪、猫和鼠)通过摄入含有传染性囊虫的生鱼而感染。钉螺的第一中间宿主主要是副钉螺和双钩螺属。大量的淡水鱼是中华绒毛虫的第二中间宿主。近几十年来，日本、韩国、中国等国对华支睾吸虫病进行了广泛的研究，在证明其超微结构、生物学、发病机制、流行病学、临床表现和化疗等方面取得了很大进展。本文主要介绍华支睾吸虫病在流行病学、病理学和临床方面的最新研究成果，以及流行区的防治措施。至于华支睾吸虫病的并发症，肝内胆道结石的形成是最具特征的病理特征之一。有时伴有化脓性胆管炎、胆囊炎、胆管性肝炎，最终可导致胆管癌。给出了与胆管细胞癌发生关系的实验结果。临床诊断的放射表现，包括胆管造影，超声和计算机断层扫描，以及磁共振成像的胆管或胰管概述。介绍了中华绒毛虫的免疫学和分子生物学研究现状。吡喹酮是治疗华支睾吸虫病的首选药物。最有效的方案是每天三次口服25 mg kg(-1)(总剂量75 mg kg(-1))，每隔5至6小时口服一天。并对防治措施进行了探讨。
Clonorchis sinensis, the Chinese or oriental liver fluke, is an important human parasite and is widely distributed in southern Korea, China (including Taiwan), Japan, northern Vietnam and the far eastern part of Russia. Clonorchiasis occurs in all parts of the world where there are Asian immigrants from endemic areas. The human and animal reservoir hosts (dogs, pigs, cats and rats) acquire the infection from the ingestion of raw fish containing infectious metacercariae. The first intermediate snail hosts are mainly species of Parafossarulus and Bithynia. Numerous species of freshwater fish serve as the second intermediate hosts of C. sinensis. Extensive studies of clonorchiasis during several decades in Japan, Korea, China and other countries have shown much progress in proving its morphological features including ultrastructure, biology, pathogenesis, epidemiology, clinical manifestations and chemotherapy The present review deals with mainly current results obtained on the epidemiological, pathological and clinical aspects, as well as control measures in endemic areas. As for the complications of clonorchiasis, formation of calculi in the intrahepatic biliary passages is one of the most characteristic pathological features. It is sometimes accompanied by suppurative cholangitis, cholecystitis, cholangiohepatitis and ultimately can cause cholangiocarcinoma. Experimental results on the relationship to the occurrence of cholangiocarcinoma are presented. Clinical diagnosis by radiological findings including cholangiography, sonography and computerized tomography as well as magnetic resonance imaging for biliary or pancreatic ducts are outlined. Current studies on immunology and molecular biology of C. sinensis were introduced. Praziquantel is the drug of choice for clonorchiasis. The most effective regimen is 25 mg kg(-1) three times daily (total dose, 75 mg kg(-1)) administered orally at 5- to 6-h intervals over a single day. Prevention and control measures are also discussed.