肺吸虫、曼氏绦虫、带绦虫、细粒棘球绦虫邹课件

Paragonimuswestermani

ParagonimuswesternaniwasfirstdescribedfromtwoBengaltigerthathaddiedinzoosinEuropein1878.Duringthenext2years,infectionsbythisworminhumanswerefoundinFurmosa.Itwasveryquicklyfoundinthelungs,brain,andvisceraofhumansinJapan,Korea,andthePhilippines.ThelifecyclewasworkedoutbyKobayashiandYokagawa.ThemajorfocusofinfectiontodayremainsintheOrient,includingIndiaandthePhilippines.ItalsoappearstobeendemicthroughouttheEastIndies,NewGuinea,theSolomonIslands,Samoa,westernAfrica,Peru,Colombia,andVenezuela.Thetaxonomyofthegenusisdifficult,andsomeofthesereportsmaybeofother,closelyrelatedspecies.Paragonimiasisisanexcellentexampleofzoonosis.

并殖吸虫Paragonimuswestermani卫氏并殖吸虫Pagumogonimusskrjabini

斯氏狸殖吸虫人兽共患型兽主人次型卫氏并殖吸虫（肺吸虫）Paragonimuswestermani卵巢子宫睾丸卵黄腺一、形态成虫卵黄腺肠支口吸盘睾丸腹吸盘子宫毛蚴胞蚴川卷螺成虫（肺）人、犬、猫、虎等

囊蚴入水（痰、粪便）体内移行穿肠壁肺穿膈肌胸腔腹腔二、生活史Lifecycle母雷蚴子雷蚴尾蚴溪蟹滞育童虫

（野猪、野鼠）卵窜扰肝、脑、皮下1、感染期：2、感染方式：3、寄生部位：4、终宿主：5、保虫宿主：囊蚴生吃含囊蚴的溪蟹、转续宿主的肉（猪肉）犬、猫、虎人生活史特点：肺、异位寄生三、致病（pathogenesis)急性期慢性期脓肿期囊肿期纤维疤痕期Theearly,invasionstagesofparagonimiasiscausefewornosymptomaticpathologicalconditions.Onceinalungoranectopicsite,thewormstimulatesconnectivetissueproliferationthateventuallywillenshrouditinabrownishorbluishcapsule.Suchcapsulesoftenulcerateandhealslowly.Eggsinsurroundingtissueswillthemselvesbecomecentersofpseudotubercles.Wormsinthespinalcordareknowntocauseparalysis,whichsometimesistotal.FatalcasesofParagonimusinthehearthavebeenrecorded.Cerebralcaseshavethesameresultsasthoseofcerebralcysticercosis.Pulmonarycasesusuallycausechestsymptoms,withbreathingdifficulties,chroniccough,andsputumcontainingbloodorbrownishstreaks.Fatalcasesarecommon.三、致病（pathogenesis)临床分型胸肺型腹型皮下包块型脑脊髓型亚临床型其他型四、诊断（diagnosis)病原学诊断免疫学诊断痰检虫卵活组织检查粪检虫卵ELISA酶联免疫吸附试验皮内试验直接涂片法五、流行与防治

(EndemityandPrevention)流行毛蚴胞蚴川卷螺成虫（肺）人、犬、猫、虎等

囊蚴入水（痰、粪便）母雷蚴子雷蚴尾蚴溪蟹滞育童虫

（野猪、野鼠）卵123传染源卵巢子宫睾丸卵黄腺一、形态成虫斯氏狸殖吸虫Pagumogonimusskrjabini第十一章

绦虫(Cestode)第一节概论P131肥胖带绦虫幼节成节孕节头节圆叶目假叶目猪带绦虫牛带绦虫曼氏迭宫绦虫四个吸盘二个吸槽有生殖孔、无子宫孔有生殖孔和子宫孔只有子宫，其余退化与成节结构相似头节：成节：孕节：CyclophyllideaPseudophyllidea前进圆叶目头节假叶目头节吸盘吸槽圆叶目成节假叶目成节圆叶目孕节假叶目孕节(曼氏迭宫绦虫)SpirometramansoniadultMorphologyP123About60-100centimeterAbout100proglottidsScolexofSpirometramansoni:finger-shapedwitheachbothriumonthedorsalandventralsurface.bothriumplerocercoid(裂头蚴)钩球蚴随粪入水成虫（小肠）猫、犬、人卵原尾蚴

人、蛇、鸟、猪食入裂头蚴裂头蚴（蛙）剑水蚤蝌蚪、人Lifecycle眼裂头蚴病皮下裂头蚴病脑裂头蚴病内脏裂头蚴病Adultwormsoccasionallyresideinhumans.Pathogenesis活组织检查免疫学诊断CT、磁共振等DiagnosisofsparganosisEpidemiologysourceofinfectionsusceptiblepopulationmodeoftransmission局部贴生蛙肉生食或半生食蛙、蛇、鸡或猪肉、马肉饮生水误食感染的剑水蚤Howinfecthumanssparganosis?吡喹酮手术摘除Preventionandcontrol肥胖带绦虫(Taeniasolium)（Taeniasaginata）猪带绦虫牛带绦虫链状带绦虫p132猪带绦虫牛带绦虫体长：成节：2-4米4-8米孕节：卵巢分三叶卵巢分二叶分支不齐，每侧有7-13支分支整齐，每侧有15-30支头节：球形，四个吸盘有顶突、小钩方形，四个吸盘无顶突、小钩前进一、形态成虫猪带绦虫牛带绦虫幼节成节孕节头节猪带绦虫牛带绦虫头节小钩吸盘吸盘头节猪带绦虫成节牛带绦虫成节3叶2叶猪带绦虫孕节牛带绦虫孕节7-13支15-30支囊尾蚴中等偏小圆球形棕黄色含一个六钩蚴卵壳很薄，易脱落胚膜呈放射状条纹大小形状颜色卵壳内容物其他虫卵胚膜六钩蚴卵壳六钩蚴成虫（小肠）人孕节(卵)随血流囊尾蚴（肌肉）

经口人误食六钩蚴囊尾蚴录像二、生活史(lifecycle)猪食入六钩蚴成虫（小肠）人孕节(卵)随血流囊尾蚴（肌肉）

经口牛食入InfectivestageDiagnosticstageOncosphereshatch,penetrateintestinalwall,andcirculatetomusculatureOncospheresdevelopintocysticerciinmuscleHumansinfectedbyingestingraworundercookedinfectedmeatEggsorgravidproglottidsinfecesandpassedintoenvironmentScolexattachestointestineAdultsinsmallintestineT.saginataT.soliumCattleandpigsbecomeinfectedbyingestingvegetationcontaminatedbyeggsorgravidproglottids三、致病（pathogenesis)猪囊尾蚴病成虫致病猪带绦虫病牛带绦虫病幼虫致病（囊虫病）自体内感染自体外感染异体感染人是如何感染猪囊尾蚴病？皮下及肌肉囊尾蚴病脑囊尾蚴病眼囊尾蚴病囊尾蚴病分型录像带绦虫病的诊断查节片问病史四、诊断（diagnosis)肛门拭子法四、诊断（diagnosis)ELISA酶联免疫吸附试验间接红细胞凝集试验IHA斑点酶联免疫吸附试验Dot-ELISA囊尾蚴病的诊断活组织检查免疫学检查CT、磁共振、眼底镜五、流行(Endemity)传染源传播途径“生皮”“过桥米线”“剁生”易感人群录像南瓜子＋槟榔吡喹酮、阿苯哒唑六、防治（Preventionandcare)手术摘除细粒棘球绦虫（包生绦虫）

EchinococcusgranulosusMorphology成虫头节幼节成节孕节棘球蚴棘球蚴实物棘球蚴虫卵：与猪带、牛带绦虫卵基本相同Lifecycle虫卵棘球蚴

成虫（犬、食肉动物）血循环（羊、牛等动物内脏）六钩蚴犬食入人、羊、牛生活史特点：1、终宿主：犬、狼、豺等；2、中间宿主：羊、牛、骆驼、猪、鹿等，偶有马、人；3、感染方式：误食入了孕节或虫卵；4、棘球蚴在人体内主要寄生部位：肝、肺、腹腔、脑等致病1、局部压迫和刺激症状：肝、肺等2、中毒和过敏症状包虫病诊断1、询问病史2、X线、CT、MRI等3、手术活检4、免疫学试验：皮试、血清学检查流行防治绵羊犬牦牛犬治疗：阿苯达唑、手术预防为主人兽共患病世界性分布，我国分布于西北、华北等农牧区1、食入未煮熟的猪肉可使人感染的蠕虫有：A牛带绦虫B猪带绦虫C曼氏迭宫绦虫D旋毛虫√选择题E肺吸虫√√√2、下列寄生虫中可引起人体幼虫移行症的有：A十二指肠钩虫B蛔虫C斯氏狸殖吸虫D日本血吸虫E曼氏迭宫绦虫√√3、引起人兽共患寄生虫病的寄生虫有：A旋毛虫B班氏丝虫C猪囊尾蚴病D华支睾吸虫√E日本血吸虫√√√4、哪种寄生虫人可以成为它的中间宿主和终宿主：A猪带绦虫B牛带绦虫C