《【大学课件】Human Parasitology—人类寄生虫.doc》由会员分享，可在线阅读，更多相关《【大学课件】Human Parasitology—人类寄生虫.doc（199页珍藏版）》请在三一办公上搜索。
1、Text Book ofHuman ParasitologyEdited by Wu Zhongdao(吴忠道)、Zheng Xiaoyin(郑小英) Section I INTRODUCTION TO PARASITOLOGYParasitology（寄生虫学）, the study of parasites（寄生虫） and their relationships to their hosts（宿主）, is one of the most fascinating areas of the biology. While it is entirely proper to classify m
2、any bacteria（细菌） and fungi（真菌） and all viruses as parasites, parasitology has traditionally been limited to parasitic protozoa（原虫）, helminthes（蠕虫）, and arthropods（节肢动物）, as well as those species of arthropods that serve as vectors（媒介）for parasites. It follows, then, that parasitology encompasses ele
3、ments of protozoology（原虫学）, helminthology（蠕虫学）, and medical arthropodology（医学节肢动物学）. Human parasitology, an important part of parasitology, study the medical parasites including their morphology(形态学), life cycle（生活史）, the relationship with host and environment. The objectives are to study the way or
4、 the measurement of parasitic diseases control. IMPORTANCE OF PARASITOLOGY Why do students need to learn the course now? In part time, parasitic infections or parasitic diseases were the most common diseases in the world. Therefore, parasitology played important role on the medicine and public healt
5、h, none neglect the important of parasitology. With the nearly simultaneous development of antibiotic drugs, synthetic pesticides（杀虫剂）, and various antiparasitic agents, it was for a time widely believed that the infectious diseases would for all practical purposes disappear from the clinical scene.
6、 Someone has asked the question, why do medical students still need to learn parasitology?Before answer the question, let me review the epidemic situation of parasitic diseases in the world. According to the WHO（世界卫生组织） 2001 year report, parasitic diseases is still an important human diseases. In th
7、e world, 210 million people reside in the endemic areas of malaria（疟疾）, 10 million cases with malaria occur every year; 20 million infected individuals was estimated in the world. So TDR/WHO has proclaimed that 10 major unconquered human tropical diseases（热带病）, African trypanosomiasis（非洲锥虫）, Dengue（
8、登革热）, Leishmaniasis（利什曼病）, Malaria（疟疾）, Schistosomiasis（血吸虫病）, Tuberculosis（结核病）, Chagas disease（夏格病又称美洲锥虫病）, Leprosy（麻风）, Lymphatic filariasis（淋巴丝虫病）, Onchocerciasis（盘尾丝虫病）. Among them 7 diseases are parasitic in the traditional sense. In addition, DDT and other insecticides（杀虫剂） not only have fail
9、ed to eliminate the vectors of malaria, schistosomiasis, and other parasitic diseases but have themselves brought on problems too well-known to require mention here. The development of resistance to the synthetic antimalarials has been an ominous occurrence in recent years. The increased mobility of
10、 large segments of the population, and popularity of the tropics and subtropics as vacation areas, exposes them to a largely undiminished threat of parasitic infection, and the speed of transportation ensures that many return to their native shores before their infections become patent. For these re
11、asons it remains necessary that all physicians have some familiarity with the parasitic diseases, no matter how “exotic”. Modifications of the environment maybe have brought about major increases in parasitic diseases, flooding of vast areas has resulted in new habitats for the snail hosts of schist
12、osomiasis. Global warming is suggested as a possible reason for the eventual spread of diseases now seen primarily in the tropics to more temperate climes. An important development of recent years has been the appearance of the human immunodeficiency virus(HIV) and its sequel, the acquired immunodef
13、iciency syndrome(AIDS), which results in greatly increased prevalence and severity of a number of parasitic, viral, and bacterial diseases. As immunosuppression becomes more widespread, not simply because of AIDS, but also as necessitated by organ transplantation, the result of cancer chemotherapy,
14、or the indiscriminate release of toxic chemicals and carcinogens into environment, heretofore unknown or extremely rare infections are being reported from human. These are the reason why the course on Human or Medical Parasitology has been keepingTable-1Current disease portfolio(from WHO report 2001
15、)TDR disease categoryDisease burdenDALYs* (thousands)Deaths(thousands)TotalMaleFemaleTotalMaleFemaleAfrican trypanosomiasis11,5851,013572503218Dengue14332861471284Leishmaniasis11,8101,067744412318Malaria240,21319,23720,9761,080522558Schistosomiasis21,7131,0376761183Tuberculosis235,79221,82913,9621,6
16、601,048613Chagas disease368036032021129Leprosy31417665221Lymphatic filariasis35,5494,2451,304000Onchocerciasis3951549402000* DALY：disability-adjusted life years(失能调整生命年)In our country, various parasites have long been recognized as one of the important endemic diseases for many years. In the early 1
17、950s, the estimated number of people suffered from schistosomiasis totaled cases 10 million, and that from malaria and filariasis, 30 million each. Since the founding of the Peoples Republic , the Chinese government has paid great attention to investigation and control of parasites, with particular
18、emphasis on the five major ones, i.e. schistosomiasis, malaria, filariasis, hookworm diseases and kala azar. Through 50 years endeavor, outstanding achievements have obtained.Nevertheless, schistosomiasis is still prevalence in lake-marsh and mountain regions along Changjiang River; at the present,
19、falciparum malaria（恶性疟疾） has not been under effective control in several southern provinces due to the emergence of multi-drug resistant strain and ecological characteristics of the vector mosquito, Anopheles dirus（大劣按蚊）, as well as population migration. Besides, a nationwide survey conducted in 198
20、8-1992 disclosed a striking number of parasite-infected population, and a high proportion of polyparasitism（多虫寄生） as well, e.g., overall prevalence of parasites was 59.67%(62.6320.339%), and more than 700 million cases of infected individuals was estimated in China Although soil-transmitted（土源性） par
21、asites infection have been reduced significantly with improvement of living conditions, food-transmitted（食源性） parasite infection, such as infection of clonorchis, have been become a new public health problem for dietary habits. So it is considered that parasitic infection /or parasitic diseases are
22、still one of the important problems in public health in our country. As a candidate for doctor, to learn some knowledge of parasitology is necessary. GENERAL CONSIDERATIONMedical (human) Parasitology consists of medical protozoology, medical helminthology, and medical arthropodology. Symbiosis（共生） S
23、ymbiosis means “living together of both members of species. Any organism that spends a portion or all its life intimately associated with another living organism of a different species is known as a symbiont( or symbiote), and the relationship is designated as symbiosis. The term symbiosis, as used
24、here, does not imply mutual or unilateral physiologic dependency;rather, it is used in its original sense(living together)without any reference to “benefit” or “damage” to the symbionts. There are at least three categories of symbiosis whose are commonly recognized: commensalisms, mutualism and para
25、sitism.Commensalism（共栖） It was from Latin for “eating at same table”, denotes an association which is beneficial to one partner and at least not disadvantageous to the other. The two partners can survive independently. Mutualism（互利共生） Mutualism is an association in which the mutualist and the host d
26、epend on each other physiologically. It is seen where such associations are beneficial to both organisms(partners). Parasitism（寄生） Parasitism is onother type of symbiotic relationship between two organisms: a parasite（寄生虫）, usually the smaller of the two, and a host（宿主）, upon which the parasite is p
27、hysiologically dependent. The relationship may be permanent ,as in the case of tapeworms found in the vertebrate intestine, or temporary, as with female mosquitoes, some leeches, and ticks, which feed intermittently on host blood. In other words, it is a symbiotic relationship in which one animal, t
28、he host, is to some degree injured through the activities of the other animal, the parasite.Parasite（寄生虫） Its biological definition is an animal or plant which lives in or upon another organism(technically called its host) and draws its nutriment directly from it. By this definition all infectious a
29、gents, viruses, bacteria, fungi, protozoa, and helminths are parasites, but traditionally protozoa , helnimths and medical arthropod（节肢动物）, so called parasites, are studied in medical or human Parasitology. Therefore, the textbooks of parasitology today deal only with protozoa, helminthes and some a
30、rthropod.The parasites broadly are of two types: endoparasite（体内寄生虫） and Ectoparasite（体外寄生虫）. The parasite which lives within the host is called the endoparasite(e.g, leishmania). Invasion by the parasite is called infection. Usually, the endoparasites cause most human diseases. The endoparasites in
31、clude 3 types, such as obligate parasite, facultative parasite and accidental parasite.Obligatove parasites(专性寄生虫) are physiologically dependent upon their hosts and usually cannot survive if kept isolated from them(e.g., Toxoplasma gondii弓形虫). Facultative parasites(兼性寄生虫)，on the other hand, are ess
32、entially free-living organisms that are capable of becoming parasitic if placed in a situation conductive to such a mode. An example of a facultative parasite is Strongyloides stercoralis（粪类圆线虫）. Accidental parasites（偶然寄生虫）, the parasite which attacks an unusual host. Ectoparasite, the parasite whic
33、h lives on the outer surface or in the superficial tissues of the host(e.g., lice). The infection by these parasites is called infestation(侵扰).Host Host is defined as an organism which harbours the parasite and provides the nourishment and shelter. These hosts, in comparison to their parasites are r
34、elatively larger in size. The hosts may be of the following types: definitive host, intermediate host, reservoir host and paratenic host etc. 1) Definitive host（终宿主） The hosts which harbour the adult parasites(e.g., Taenia saginata causing intestinal taeniasis), most highly developed form of the par
35、asite(e.g., Trypanosoma cruzi causing African sleeping sickness) or where the parasite replicates sexually(e.g., Paragonimus westermani) are called the definitive hosts. The definitive hosts may be human or non-human living things.2) Intermediate host（中间终主） The hosts which harbour the larval stages
36、of parasite development or the asexual forms of the parasite are called intermediate host. Some times two different hosts may be required to complete different larval stages. These are known as the first and second intermediate hosts respectively(e.g., snails钉螺 are the first intermediate hosts and f
37、resh water fish are the second intermediate hosts for Clonorchis sinensi肝吸虫s).3) Reservoir host（保虫宿主） The animal which harbours the parasites and serves as an important source of infection to other susceptible hosts are known as reservoir host(e.g., water buffalo is the reservoir host for schistosom
38、iasis血吸虫病).4) Paratenic host or transport host（转续宿主） The larva of some parasites can invade a non-normal host, but can not develop, and only keep the larva stage. If the larva enter a normal definitive host, it can continue to develop into adult worm. The non-normal host is called paratenic host or
39、transport host. It functions as a transport or carrier host.TAXONOMY（分类学）According to the biomial nomenclature（命名法） as suggested by Linnaeus(“Systema Nature” 1758),each parasite has two names: a Genus(属名) and a Species name（种名）. These names are derived either from Greek or Latin words Names of their
40、 discoverers Geographical area where found Hosts in which parasites are found, or Habitat of the parasiteThe correct scientific name of the parasite consists of the genus and species to which it belong, the name of the designator and the year in which it was discovered(e.g., Angiostrongylus cantonen
41、sis管圆线虫(Chen, 1935) Dougherty, 1946).The animal parasites of human and most vertebrates are contained in five or more major subdivisions or phyla（门）. Phylum Sarcomastigophora(肉鞭毛虫门). This phylum is divided into two subphyla: the Mastigophora or flagellates(鞭毛虫纲), and the Sarcodina or amebae（肉足纲）. Ph
42、ylum Apicomplexa(顶复门) Members of this phylum are tissue parasites.Apicomplexa have a complex life cycle with alternating sexual and asexual generations.Phylum Microspora(微孢子门) Members of the Microspora are minute intracellular parasites of many kinds of vertebrates and invertebrates, and they differ
43、 significantly in structure from the Apicomplexa. Microsporidia rarely cause diseases in immunocompetent persons, but many do so with greater frequency in immunosuppressed persons.Phylum Ciliophora(纤毛虫纲) The ciliates include a variety of free-living and symbiotic species. The only ciliate parasite o
44、f human is Balantidium coli, found in the intestinal tract. Although rare, it is important, as it may produce severe intestinal symptoms.Phylum Platyhelminthes(扁形动物门) The Platyhelminthes, or flatworms, are multicellular animals characterized by a flat, bilaterally symmetric body. Most flatworms are
45、hermaphroditic, having both male and female reproductive organs in the same individual. The sexes are separate in the schistosomes. The classes Trematoda and Cestoda contain parasitic forms only.Phylum Aschelminthes(蛔线虫门) The nematodes, or roundworms, are elongate, cylindrical worms, frequently atte
46、nuated at both ends. The sexes are separate, the male frequently being considerably smaller than the female. A well-developed digestive tract is present. While most nematodes are free-living(e.g., Caenorhabditis elegans), a large number of species parasitize humans, animals, and plants. Intermediate
47、 hosts are necessary for the larval development of some forms. Parasites of humans include intestinal and tissue-inhabiting species.Phylum Acanthocephala(棘头虫门) The thorny-headed worms are all endoparasite organisms. While thorny-headed worms are widely distributed among wild and domestic animal, onl
48、y three genera have been reported in human beings including Macracanthorhynchus hirudinaceus(猪巨吻棘头虫).Phylum Arthropoda(节肢动物门) The phylum is subdivided into a number if classes, many of which are of medical importance. The classes main include the Class Arachnida(蛛形纲) and Class Insecta(昆虫纲). The Arachnida, or spiderlike animals, possess a body divided into two parts, the cephalothorax and the abdomen. Adults have four pairs of legs. Included in this class are the scorpions, the spiders, and the ticks and mites. Certain ticks and m
