蛔虫、钩虫、蛲虫课件

IntroductiontotheHelminths蠕虫Helminthsmeansworms,multicellularorganisms.

PhylumClassNemathelminthes

Nematoda(roundworm)线虫纲线形动物门Platyhelminthes

Tremetoda(flatworms)吸虫纲扁形动物门Cestoda

绦虫纲TheNematodes线虫

Therearemany,manynematodes2006诺贝尔奖:ＲＮＡ干扰机制2002年诺贝尔奖：程序性细胞死亡C.ElegansMorphologyCylindrical,non-segmented,bilaterallysymmetricalandsexesseparatePseudocele原体腔(pseudocoelom)

Thebodywall:

cuticle角皮层

hypodermis皮下层longitudinalmuscle肌层DigestivesystemMouthpharynxesophagusintestineanus咽管食管肠管肛门Reproductivesystem

malereproductivesystemTestisseminalvesicle

睾丸储精囊

vasdeferens

输精管

ejaculatoryduct

射精管

Mostfemalesusuallyhavetwoovaries，oviducts

anduterus..ovary—oviduct—uterus.ovary—oviduct—uterus..

卵巢输卵管子宫

vulva-vagina

阴门阴道Excretorysystem

Excretoryporeisanterior.

排泄孔Noflamecellsarepresent.lifecycle

M1M2M3M4

EggL1L2L3L4Adultlarva(male&female)

KindsoflifecycleinnematodesAscarislumbricoides

Trichuristrichiura

EnterobiusvermicularisHookwormsIndirectlifecycle:intermediatehostisnecessary

TrichinellaspiralisFilariaDirectlifecycle:Intermediatehostisnotnecessary土源性线虫（肠道线虫）生物源性线虫INTESTINALHELMINTHS

Ascarislumbricoides(roundworm)似蚓蛔线虫Trichuristrichiura(whipworm)毛首鞭形线虫Enterobiusvermicularis(pinworm)蠕形住肠线虫AncylostomaduodenaleandNecatoramericanus(hookworms)钩虫

2004年第二次寄调Hookworms

Fivespeciesofhookworms:

Ancylostmaduodenale十二指肠钩口线虫

Necatoramericanus美洲板口线虫Ancylostmaceylanicum锡兰钩口线虫Ancylostmacaninum犬钩口线虫Ancylostmabrazilience巴西钩口线虫Adultliveintheintestineandtakebloodfromthehost,causehookwormdisease.Numberofhumansinfectedisestimatedat1.2billionwith50,000to60,000deathseachyear.国内：

6.12%Enterobiusvermicularis(Pinworm)Almostanybodycanbecomeinfectedwiththisparasite，especiallychildren.Theworldwideinfectionisabout210million国内：10.28%Morphology－AdultofAscarislumbricoides

thelargestnematodeparasitesofhumansCreamywhiteorpinkishincolorelongateandcylindricalFemale:measuring35cmlong,posteriorendisstraightMale:measuring25cmlong，posteriorendiscurved.Morphology－AdultsofAscarislumbricoides

Threelipsaroundthemouthin“品”typeandpossesssmallteethMorphology－AdultsofAscarislumbricoides

Morphology－AdultsofEnterobiusvermicularis

Adults:pin-like,white,smallwormFemaleshowingesophagealbulb&cephalicalae

Malewithcurvedposteriorend,Femalehasalongpointedend.咽管球头翼Morphology－AdultsofhookwormsAdult:Slender,pinkishorcreamy-grayincolor,about10mminlength.MorphologyofNecatoramericanusBuccalcapsulecontainsapairofventralanddorsalcuttingplates.Copulatorybursacontainsspiculesthatarefuseddistally.shape“c”,1cm±“s”,1cm±buccalcapsuleflatandoval-shapeoval-shapetwopairsonepaircuttingplatesCopulatorybursaroundoblatespiculetwo,separatedtwo,fusedattheirends

A.duodenale

N.americanusDifferencebetweenA.duodenaleandN.americanusMorphology－larvaofhookworms

rhabditiformLarva杆状蚴

filariformlarva:infectivestageEggsareunembryonatedwhenpassedinthefeces.Embryonationoccursinthesoil.UnembryonatedegginfecesbroadlyovalyellowishtobrownincolorThickshellovumproteincoatfertilizedMorphology－EggsofAscarislumbricoides

unfertilizedandfertilized

egg

Decorticatedegg(lostouteralbuminouscoating)EmbryonatedegginsoilMorphology－EggsofAscarislumbricoides

Morphology－EggsofTrichuristrichiura

size:50-54µmby22-23µm,smallerthanAscarids’Shape：atypicalbarrelColor：yellow-brownunstainedtwopolarplugsShell：

quitethick

Contains：

unembryonatedeggMorphology－EggsofEnterobiusvermicularissize:smallerthanAscarids’Shape：oval,flattenedononesideColor：colorlessShell：

quitethick

Contains：anundevelopedlarvainsideShape:oval-roundShell:thinwithsmoothandcolorless(transparent)eggshellSize:57-76µmby35-47µmContains:clearspacebetweentheegg-shellandtheovum.Usually2to16cellsinfecesMorphology－EggsofhookwormsMorphology－EggsofhookwormsLifecycle

LifecycleofAscarislumbricoides

Adultegginfectiveegglarva

IngestedbymanmigrationLifecycleMigrationoflarvainthehost:Vesselsofintestineliverheartlungs

trachea

pharynxintestine(swallowed)LifecycleofhookwormLifeCycle

Adulteggrhabditiformfilariformlarvalarva

Swallowedpharynxtrachealungcirculation

Penetrateskin

LifecycleofEnterobiusvermicularis

Lifecycle

ingestedAdultegginfectiveegg(inlumenofcecum)PathogenesisPathogenesisofAscarislumbricoides

larvae:AscarisPneumonitisAsthmaLarvainsectionoflungPathogenesis2)Adults：

(1)Malnutrition(2)Disorderofdigestivesystem:maincomplaint---abdominalpain(3)Allergicresponses

anorexia(食欲不振)nausea(恶心)vomiting(呕吐)diarrhea(腹泻)Complication并发症

penetratetobileductspenetratetothepancreaticandtheappendix胆道蛔虫症胰腺阑尾intestinalobstruction肠梗阻

Ectopicparasitism异位寄生1.causeirritation(pruritus搔痒)oftheanalregionSecondarybacterialinfectioninareasscratchedrawmayoccur.vaginitisandrarelysalpingitisinyounggirls.

阴道炎输卵管炎3.causementalanguishPathogenesisofEnterobiusvermicularis

Pathogenesisofhookworm1.Localdermatitis(grounditch)钩蚴性皮炎

2.Pulmonary(pneumonia-like)symptoms(symptomsarenotassevereasAscarismigration)3.Anemia

a.Thewormsucksbloodandthewoundoozesblood

A.duodenaletakes0.26ml/day;N.americanus0.03ml/dayb.Thewormusuallychangesitssuckingsitec.Disfunctionofintestinetoabsorbirongraduallyproduceaniron-deficiencyanemiagastroentericsymptoms胃肠道症状

Slight,intermittentabdominalpainAberrationofappetite(geophagy异嗜症).lossofnormalappetiteanddesiretoeatsoilorun-normalmaterials6.Hookwormdiseasesofinfant7.eosinophiliaLaboratoryDiagnosisLaboratoryDiagnosis1.Byidentifyingtheeggs1.directfecalsmear

2.brine-floatationmethod（饱和盐水浮聚法）3.Scotchtapetechnique(cellophanetapeimpression)透明胶纸黏贴法

4.Larvalcultivation(钩蚴培养法)2.Byidentifyingtheadults3.therapeutictestEpidemiologydistributionBasicconditionsinparasiticepidemiologyPatientsandinfectedpersonsSouceofinfectionModeoftransmission(Factorsofprevalence)ForroundwormForhookwormViamouth

WarmerandpoorsanitationInadequatedisposaloffecesUsingnightsoilasfertilizerViaskin

Bare-footwalkingOthers:Oral（A.doudenale)PlacentaMother’smilkParatenichostsSusceptiblepopulation“Hand-to-Mouth”TransmissionretroinfectionthroughanusinhalationofovaForpinwormEpidemiologythereasonforwidedistributionofAscaris

l1.simplelifecycle2.high