课件：蛔虫、鞭虫、钩虫.ppt

Ascaris. lumbricoides(似蚓蛔线虫),一、morhpology(形态),1531cm,Adult Ascaris worms: Female and male Ascaris lumbricoides,2019,-,1,This worm is a female, as evidenced by the size and genital girdle(生殖孔).,2019,-,2,“品”,A scanning electron micrograph of the anterior end of Ascaris showing the three prominent lips .,2019,-,3,fertilized egg-infective (受精卵),unfertilized egg -not infective (未受精卵),A “decorticated“ fertilized egg (脱蛋白质膜受精卵),2019,-,4,2019,-,5,二、life cycle (生活史),2019,-,6,感染期卵,录像,基本发育过程:,2019,-,7,侵入肠粘膜的小V、小L,Larva migration route (幼虫移行途径):,2019,-,8,生活史的特点：,1.Parasitic location： 2.Infective stage: 3.Infection atrium:,small intestine,infective egg,Mouth(eating contaminated food or water ),4.Adult female can produce 200,000 eggs per day.,2019,-,9,三、 signs and symptoms,录 像,1、幼虫致病,2、成虫致病,蛔虫性哮喘、肺炎,掠夺营养,变态反应 哮喘,荨麻疹,2019,-,10,并发症 (国内报告 8468例),胆道蛔虫症 4556例(53.8%) 蛔虫性肠梗阻 2337例(27.6%) 蛔虫性阑尾炎 143例 蛔虫性胰腺炎 17例 蛔虫性哮喘 1352例 蛔虫性肝脓肿 33例,2019,-,11,A large mass of Ascaris lumbricoides live in the intestinal tract and can cause intestinal obstruction.,2019,-,12,direct wet mount examination of the feces (粪便直接涂片法),四、 diagnosis（诊断),流行,五、 Endemity and Prevention (流行与防治),防治,2019,-,13,Whipworm One of the most common parasites of humans Distributed throughout the world in the same areas where ascaris and hookworm are found,Trichuris trichiura (毛首鞭形线虫),2019,-,14,The anterior portion of the body is long and slender, posterior portion widens and thickens, like bullwhip Female is longer than male, 35-50 millimeter (mm).,2019,-,15,Eggs measure 50 to 54 m by 22 to 23 m. typically barrel-shaped(纺锤状）, with two opercular plug(盖塞）,Trichuris trichiura egg,2019,-,16,成虫,（盲肠）,卵,随粪入土,潮湿、荫蔽、O2充足 21-30。C,感染期卵,经口误食、孵出幼虫、无体内移行,蛔虫生活史：,鞭虫生活史:,2019,-,17,(十二指肠钩口线虫),钩虫,(美洲板口线虫),Ancylostoma duodenale,Necator americanus,(Hookworm),2019,-,18,19,Differential characteristic of A.duodenale and N.americanus,size: A.duodenale is larger than N.americanus. Shape: A.duodenale likes the letter “C” N.americanus likes the letter “S”,2019,-,19,Scanning electron micrograph of the oral opening of Ancylostoma duodenale.Note the presence of four cutting “teeth,“ two on each side. Necator americanus: The oral opening of this species contains cutting “plates“ ,no “teeth.“,(十二指肠钩虫:两对钩齿),(美洲钩虫:一对板齿),Buccal capsule (口囊),2019,-,20,Bursa & dorsal ray,Long, wide and rounded, dorsal ray tripartite,Broader than long , dorsal ray small,bipartite,2019,-,21,与钩虫吸血有关的结构,口囊内有钩齿或板齿.,咽管壁肌肉发达.,虫体前端的三种腺体.,分泌抗凝素及Ach酶,分泌Ach酶、蛋白酶及胶原酶,分泌蛋白酶,2019,-,22,Hookworm egg:,medium size a thin eggshell, transparent 2-4 cells within egg (Uncleaved embryos),Eggs of A. duodenale and N. americanus are indistinguishable,钩虫卵,2019,-,23,Hookworm life cycle,(1) Eggs are passed in feces to the soil .,(2)The released rhabditiform larvae grow in the feces and/or the soil,(3) Rhabditiform become filariform (third-stage) larvae that are infective,(4)Filariform larvae penetrate the skin.,(5)Filariform larvae are carried through the veins to the heart and then to the lungs. They penetrate into the pulmonary alveoli, ascend the bronchial tree to the pharynx, and are swallowed.,(6)The larvae reach the small intestine, where they reside and mature into adults,2019,-,24,生活史,2019,-,25,侵入皮肤小V、小L,Migrantion path:,移行,2019,-,26,生活史的特点：,1、寄生部位： 2、感染期： 3、感染途径： 4、感染方式： 5、迁延移行： 6、丝状蚴特性： 7、转续宿主：,小肠,丝状蚴,皮肤、口、胎盘、乳汁等,接触泥土、生食蔬菜和转续宿主肉类、母婴传播等,向温性,猪、犬、灵猫等,停滞发育达200多天,2019,-,27,Clinical features of hookworm disease,Site,Symptoms,Pathogenesis,Cutaneous invasion and subcutaneous migration of larva,Pulmonary (呼吸系统),Gastro- intestinal (胃肠道),Hematologic (血液),Local erythema, macules, papules (ground itch),Dermal(皮肤),Bronchitis, pneumonitis and, sometimes, eosinophilia,Migration of larvae through lung, bronchi, and trachea,Anorexia, epigastric pain and gastro-intestinal hemorrhage,Attachment of adult worms and injury to upper intestinal mucosa,Iron deficiency anemia,Intestinal blood loss,录 像,Pathogenesis and Symptomatology,2019,-,28,贫血的原因：,边吸血边排血 咬附部位渗血 更换咬附位置，原伤口仍渗血 虫体活动造成组织、血管损伤引起失血.,Hookworm anemia Microcytic hypochromatic Anemia (小细胞低色素性贫血),2019,-,29,diagnosis,Finding the characteristic eggs in the feces . Saturated salt solution flotation method . (饱和盐水浮聚法) Hookworm larvae culture method .,2019,-,30,（1）Infection source ：Patients and carriers,（2）Transmission means ：Infective larvae penetrate the skin percutaneous route , oral route(maybe),（3）Susceptible population ：human,录像,Endemity and Prevention,2019,-,31,被钩蚴污染的尿布；,睡沙袋、穿“土裤子”；,经胎盘感染；,经乳汁感染；,婴儿感染钩虫的原因,2019,-,32,后面内容直接删除就行 资料可以编辑修改使用 资料可以编辑修改使用 资料仅供参考，实际情况实际分析,感谢您