绦虫-英文课件.ppt

Cestodes,DepartmentofPathogenicBiology,Reviewsomeimportantconcepts,Lifecycle(寄生虫生活史)Thelifecycleofaparasiteisdefinedasthewholebiologicalcourseofgrowth,developmentandreproductionofaparasite,orofgrowth,developmentandreproductionofaparasitethatistransmittedfromonehosttoanotherhostofthesamespecies.,Definitivehost(finalhost)终宿主Thoseprovidethelivingofadultofhelminthorsexualstageofprotozoanarecalleddifinitivehost.,Intermediatehost(中间宿主)Thoseprovidethelivingoflarvalofhelminthorasexualstagesofprotozoanarecalledintermediatehosts.（1）thefirstintermediatehost（2）thesecondintermediatehost,Reservoirhost(保虫宿主)Theanimalwhichharbourstheparasitesandservesasanimportantsourceofinfectiontoothersusceptiblehostsareknownasreservoirhost.,Paratenichost(transporthost)转续宿主Thelarvaeofsomeparasitescaninvadeanon-normalhost,butcannotdevelop,andonlykeepthelarvastage.Ifthelarvaeenteranormaldefinitivehost,itcancontinuetodevelopintoadultworm.Thenon-normalhostiscalledparatenichostortransporthost.Itfunctionsasatransportorcarrierhost.,Classcestoda(Morethan30cestodescanparasitizehumanbeing),1.Themainfeatureoftheclasscestodesare.2.ThemorphologicaldifferencesbetweenT.saginataandT.solium3.ThelifecycledifferencesbetweenT.saginataandT.solium4.Thewayofacquiringinfectioncysticercosis5.Thewayofacquiringinfectiontaeniasis6.Pathogenesisandclinicalmanifestationoftaeniasisare7、Livinginofcysticercosis,Question,8、Themaindiagnosticmethodoftaeniasisare9、Themaindiagnosticmethodofcysticercosisare10、Howtopreventtaeniasis？,MORPHOLOGY,1、Adultwormisflat,symmetric,multisegmentedandribbon-shapedworms.Lengthofadultwormisfrommillimetertometer.(e.g.,LengthofEchinococcusgranulosus细粒棘球绦虫is2-7mm,LengthofTaeniasaginate牛带绦虫is8m)Adultwormconsistsofproglottis.(e.g.,Echinococcusgranulosus细粒棘球绦虫has4proglottis.Taeniasaginate牛带绦虫has10002000proglottis),Echinococcusgranulosus,Taeniasaginate,2、Thecestodeslackanytraceofadigestivetractandthereforemustabsorballrequiredsubstancesthroughtheirexternalcovering.,3、Scolexisprovidedwithsuckerorgrooves(吸槽)；4、Thecestodesarehermaphrodite(雌雄同体).Usuallyeachproglottidhasonecompletesetofbothmaleandfemalesystems.,LIFECYCLE,1、Cestodescompletetheirlifecycleintwoorthreedifferenthosts（exception:Hymenolopisnana短膜壳绦虫）2、Adultwormsliveintheintestineofvertebrates(脊椎动物).,PATHOGENESISandPATHOLOGY,1、Adultworm：Adultwormsarefoundinthesmallintestine;theseinfectionsareusuallywelltoleratedorasymptomatic,butmaycauseabdominaldistress,dyspepsia,anorexia(orincreasedappetite),nausea,localizedpain,anddiarrhea.Reason:physicalstimulation,chemicaldamages.,2、Larvae：Cestodeslarvaecaninvadealmostanyinternalorganinahumanbeing,andmaycauseseriouspathologicaldamages.,Ifinvadingeyeorbrain,theinfectionwillhaveseriousconsequences.(e.g.,Hydatidcyst棘球蚴isbroken，thecontentofthecystwillcausehypersensitivity过敏,shockordeath.,牛带绦虫Taeniasaginata（肥胖带绦虫、无钩绦虫、牛肉绦虫）,MORPHOLOGY,1、Adultwormislong,flat,whiteincolor.multisegmentedandribbon-shapedworms.,Taeniasaginataadultworm,A,B:Taeniasaginataadultworm,A,B,Scolexissmall,1mmindiameterandhasfoursuckers.Neckisshortand5-10mmlongandaboutone-halfasthickashead.Itcontainsgerminalcellsthatapparentlyareresponsibleforgivingrisetonewproglottids.,scolex,suckers,Neck(germinalcells),ThescolexandneckofT.saginata,ThescolexandneckofT.saginata,Immatureproglottidsarerectangles.Theyarebroaderthanlong.Thereproductivesystemsisimmature.,Strobilus,Matureproglottidsaresquare.Eachproglottidhasonecompletematuresetofbothmaleandfemalesystems.Eachovaryhaslobes.,Gravidproglottidsarerectangles.Theyarelongerthanthebroad.Eachuterusiscrowdedwitheggs.EachUterusbecomesbranches.,ThematureproglottidsofT.saginata,ThegravidproglottidsofT.saginata,lateralbranches,stem,ThegravidproglottidsofT.saginata,Summary,T.saginataEntirebodyLength(m)48Proglottids(number)10002000thick、opaqueScolexsquarerostellumAbsenthooksAbsentMatureProglottidsovary(numberoflobes)2GravidProglottidsUterus(numberofbrancheseachside)1530,2、Cysticercus,CysticercusisthelarvalstageofTaenia.Itis14-20u,small,ovalandmilkywhitebladder-likestructure.Itisfilledwithfluid.Theouter：cortexbladderwallTheinner：间质层（Itshowsasmallwhitespotrepresentingthefutureheadinvaginatedintothebladder.）,cysticercusofT.saginata,CysticercusofT.saginata,3、Egg(measure,shape,color,shell,contain),brownincolor,about31-43umindiameter,roundinshape,withathickradiallystriatedbrownshell.Insideeachshellisanembryonatedoncospherewith6hooks.Theoutershellisthin,transparentanddoesnotalwaysremainwiththeeggs.,Egg,oncosphere,shell,embryophore,Egginhumanfeces,Egginthegravidproglottids,A,B:Taeniideggs.Theeggsareroundedorsubspherical,diameter31to43m,withathickradiallystriatedbrownshell.Insideeachshellisanembryonatedoncospherewith6hooks.TheegginFigureBstillhastheprimarymembranethatsurroundseggsintheproglottids.,A,B,lifecycle,lifecycle,Adultworm,gravidproglottid,oncosphere,cysticercus,Adultworm,intestineofhumanbody),invadetheintestinalwall,tissueororgan,cattle,human,circulatorysystem,infectedmeat,T.saginataLivinginadultwornintestineCysticercusdontharbourDefinitivehosthuman（single）Intermediatehostcattle、sheepInfectivestageCysticercus,2、Thewayofacquiringinfectiontaeniasis,T.Saginatataeniasis：AhumaningestT.Saginatacysticerciinraworundercookedmeat.,Pathogenesisandclinicalmanifestation,Adultworm（T.saginata）1、intakingnutrientsandnegativelyaffecttheabsorption2、damagingintestinemucosa：vagueabdominaldiscomfort、chronicindigestion、diarrhea、orweightloss.3、intestinalobstruction.4、Thegravidproglottidsbecomeseparatedfromthestrobilaandmigrateoutoftheanus5、ectopicparasitism：uterustract、eustachiantube（T.saginata）,DIAGNOSISintestinaltaeniasis,1、Questioningthehistoryofeatingraworundercookedmeat；dischargedthegravidproglottidsinthefaeces.,2、pathogenicdiagnosis：a、肛门拭子法（透明胶纸法、棉签拭子法）TheeggsofTaeniasaginataareindistinguishablemorphologically(morphologicspeciesidentificationwillhavetorelyontheproglottidsorscolices).b、gravidproglottidsexaminationspeciesdetermination、preventingtoinfectc、fecesexaminationDirectsmearsmethod(直接涂片法）Sedimentationmethod(沉淀集卵法）饱和盐水浮聚法、）d、scolexexaminationspeciesdetermination,Epidemiology,distributionTheworld：T.saginataareaworldwidedistribution.ItisprevalentinEurope、CentralandSouthAmerica、SoutheastAsia.,China：endemicareas，especialnationalminority；T.saginatataeniasis：thecaseswerefoundfrom20provinces,cities.MajorendemicareasarelocatedinXinjiang,Neimeng,Xizang,Guangxi,Guizhou,especialXizang.,Epidemicfactor1、Reservoirofinfection：Patients,carrier.Humanisonlydefinitivehostandreservoirofinfection.2、infectingintermmediateandraisingwronghabits：,3、badeatinghabits（themostimportant）1）eatingraworundercookedmeat.2）eatingfoodcontaminatedwithcysticerci.,preventionandcontrol(eliminate驱、administer管、diagnosis检),1、treatingthepatientsandcarrier：（1）thetreatmentofintestinaltaeniasispraziquantel吡喹酮南瓜子+槟榔attention：A、earlydetectionandchemotheraphyfortaeniasisB、avoidanceofvomitingC、eliminatethescolexandneck,猪带绦虫Taeniasolium（链状带绦虫、有钩绦虫、猪肉绦虫）,MORPHOLOGY,1、Adultwormislong,flat,whiteincolor.multisegmentedandribbon-shapedworms.,Scolexissmall,1mmindiameterandhasfoursuckers.Neckisshortand5-10mmlongandaboutone-halfasthickashead.Itcontainsgerminalcellsthatapparentlyareresponsibleforgivingrisetonewproglottids.,Immaturesegmentsarerectangles.Theyarebroaderthanlong.Thereproductivesystemsisimmature.,Strobilus,Matureproglottidsaresquare.Eachproglottidhasonecompletematuresetofbothmaleandfemalesystems.Eachovaryhaslobes.,Gravidproglottidsarerectangles.Theyarelongerthanthebroad.Eachuterusiscrowdedwitheggs.EachUterusbecomesbranches.,T.solium,scolex,suckers,Neck(germinalcells),ThescolexandneckofT.solium,rostellum,hooks,ThescolexandneckofT.solium,rostellum,hooks,ThematureproglottidsofT.solium,ThegravidproglottidsofT.solium,stem,lateralbranches,ThegravidproglottidsofT.solium,Summary,T.soliumEntirebodyLength(m)24Proglottids(number)7001000thin、transparentScolexroundshaped、rostellumPresenthooks25-50MatureProglottidsovary(numberoflobes)3GravidProglottidsUterus(numberofbrancheseachside)713,ThemorphologicaldifferencesbetweenT.saginataandT.solium,T.soliumT.saginataEntirebodyLength(m)2448Proglottids(number)700100010002000thin、transparentthick、opaqueScolexroundshaped、squarerostellumPresentAbsenthooks25-50AbsentMatureProglottidsovary(numberoflobes)32GravidProglottidsUterus(numberofbrancheseachside)7131530,2、Egg（TheeggsofT.saginataandT.soliumareindistinguishable)(measure,shape,color,shell,contain),brownincolor,about31-43umindiameter,roundinshape,withathickradiallystriatedbrownshell.Insideeachshellisanembryonatedoncospherewith6hooks.Theoutershellisthin,transparentanddoesnotalwaysremainwiththeeggs.,Egg,oncosphere,shell,embryophore,Egginhumanfeces,Egginthegravidproglottids,A,B:Taeniideggs.Theeggsareroundedorsubspherical,diameter31to43m,withathickradiallystriatedbrownshell.Insideeachshellisanembryonatedoncospherewith6hooks.TheegginFigureBstillhastheprimarymembranethatsurroundseggsintheproglottids.,A,B,3、Cysticercus,CysticercusisthelarvalstageofTaenia.Itis14-20u,small,ovalandmilkywhitebladder-likestructure.Itisfilledwithfluid.Theouter：cortexbladderwallTheinner：间质层（Itshowsasmallwhitespotrepresentingthefutureheadinvaginatedintothebladder.）,cysticercusofT.solium,cysticercusofT.solium,lifecycle,Adultworm,gravidproglottid,oncosphere,cysticercus,Adultworm,intestineofhumanbody),invadetheintestinalwall,tissueororgan,pig,human,circulatorysystem,infectedmeat,Adultworm,intestineofhumanbody),eggs,oncosphere,cysticercus,HumanswalloweggsofT.Solium,invadetheintestinalwall,circulatorysystem,tissueororgan,T.soliumLivinginadultwornintestineCysticercussubcutaneous、eyes、brain、musclesDefinitivehosthuman（single）Intermediatehostpig、humanbeingInfectivestagecysticercus、egg,ThelifecycledifferencesbetweenT.saginataandT.soliumandcysticercus,1、T.soliumT.saginataLivinginadultwornintestineintestineCysticercussubcutaneous、eyes、brain、musclesdontharbourDefinitivehosthuman（single）human（single）Intermediatehostpig、humanbeingcattle、sheepInfectivestageCysticercus、eggCysticercus,2、Thewayofacquiringinfectiontaeniasis,T.Soliumtaeniasis：AhumaningestT.Soliumcysticerciinraworundercookedpork.,3、Thewayofacquiringinfectioncysticercosis,Humansswalloweggsorgravidproglottids,theoncospherecandevelopbladderwormlikeinpig.Internal-autoinfection(自体内感染)：agravidproglottidmaymigratefromthelowerintestinetothestomachorduodenum,oritmaybecarriedtherebyreverseperistalsis.Auto-infection(自体外感染)：personswhoareinfectedwithwormsmaycontaminatetheirhouseholdsorfoodwitheggsthatareaccidentallyeatenbythemselves.Hetero-infection(异体感染)：ingestionoftheeggsincontaminatedfoodorwater.,Pathogenesisandclinicalmanifestation,Adultworm（T.solium）1、intakingnutrientsandnegativelyaffecttheabsorption2、damagingintestinemucosa：vagueabdominaldiscomfort、chronicindigestion、diarrhea、orweightloss.3、intestinalobstruction.4、Thegravidproglottidsbecomeseparatedfromthestrobilaandmigrateoutoftheanus5、ectopicparasitism：subcutaneous、thyroidgland（T.solium）,ThelarvaeorCysticercuscellulosae,16-25%patientsofT.soliumtaeniasishaveCysticercuscellulosae，and55.6%patientsofCysticercuscellulosaehaveT.soliumtaeniasis。,1、Muscle、subcutaneouscysticercosis：subcutaneousnodules：palpable、numberfromonethousandmild：asymptomaticserious：musclepain、cramp、fatigue,2、Neurocysticercosis：（themostserious）Livingin：cerebrum(脑实质)、ventriclesandsubarachnoidspace(蛛网膜下腔)、脑室mild：asymptomaticserious：epileptiformfits癫痫发作、intracranialhypertension颅内高压、psychiatricdisorder精神症状；,3、Ocularcysticercosis：Livingin：mostindeepofeye，vitreoushumour(玻璃体)、d：chorioretinitis脉络膜视网膜炎ridocyclitis虹膜睫状体炎serious：blind,DIAGNOSISintestinaltaeniasis,1、Questioningthehistoryofeatingraworundercookedmeat；dischargedthegravidproglottidsinthefaeces.,2、pathogenicdiagnosis：a、肛门拭子法（透明胶纸法、棉签拭子法）TheeggsofTaeniasaginataandT.soliumareindistinguishablemorphologically(morphologicspeciesidentificationwillhavetorelyontheproglottidsorscolices).b、gravidproglottidsexaminationspeciesdetermination、preventingtoinfectc、fecesexaminationDirectsmearsmethod(直接涂片法）Sedimentationmethod(沉淀集卵法）饱和盐水浮聚法、）d、scolexexaminationspeciesdetermination、,Cysticercosis,1、pathogenicdiagnosis：biopsy（Muscle、subcutaneous）2、serologicaldiagnosis：IHA（间接RBC凝集试验）ELISA（酶联免疫吸附试验）DOT-ELISA（斑点酶联免疫吸附试验）3、adjunctexamination：funduscope（Ocularcysticercosis）CT、MR（Neurocysticercosis）,Epidemiology,distributionTheworld：T.soliumandT.saginataareaworldwidedistribution.theyareprevalentinEurope、CentralandSouthAmerica、SoutheastAsia.,China：endemicareas，especialnationalminority；T.soliumtaeniasis：thecaseswerefoundfrom27provinces,cities.MajorendemicareasarelocatedinYunan,Heilongjiang,Jiling,etc,especialHeilongjiang.,Epidemicfactor1、Reservoirofinfection：Patients,carrier.Humanisonlydefinitivehostandreservoirofinfection.2、infectingintermmediateandraisingwronghabits：,3、badeatinghabits（themostimportant）1）eatingraworundercookedmeat.2）eatingfoodcontaminatedwithcysticerci.,preventionandcontrol(eliminate驱、administer管、diagnosis检),1、treatingthepatientsandcarrier：（1）thetreatmentofintestinaltaeniasispraziquantel吡喹酮南瓜子+槟榔attention：internal-autoinfectionA、earlydetectionandchemotheraphyfortaeniasisB、avoidanceofvomitingC、eliminatethescolexandneck,(2)cysticercosisMuscle、subcutaneousandOcularcysticercosissurgery,praziquantel吡喹酮Neurocysticercosispraziquantel吡喹酮、albendazole阿苯哒唑。,2、changingbadeatinghabits（themostimportant）(1)improvementofpersonalanddiethygiene,forexamplewashinghandsbeforteatingandafterexcreing.(2)usingtoilet,dontexcretefecesfreely.Preventingtocontaminateprairie(牧场)andwater.(3)avoidanceofeatingraworuncookedmeat.,3、inspectionofmeatforthecysticerci,andforbidtosalemeatwithcysticerci.4、changingpigsandcattlehushandrymethods.,1.Themainfeatureoftheclasscestodesare.2.ThemorphologicaldifferencesbetweenT.saginataandT.solium3.ThelifecycledifferencesbetweenT.saginataandT.solium4.Thewayofacquiringinfectioncysticercosis5.Thewayofacquiringinfectiontaeniasis6.Pathogenesisandclinicalmanifestationoftaeniasisare7、Livinginofcysticercosis,Question,8、Themaindiagnosticmethodoftaeniasisare9、Themaindiagnosticmethodofcysticercosisare10、Howtopreventtaeniasis？,美国寄生虫学家学会：./aspWHO热带病控制署：http:/www.who.ch/programmes/ctd/ctd_home.html寄生虫学资源主页:http:/www.pasteur.fr/Bio/parasito/Parasites.html寄生虫病：http:/www.mic.ki.se/diseases/c3.html,TaeniasaginataTaeniasolium,Manistheonlydefinitivehostofthesea