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1、链状带绦虫(猪带绦虫)Taenia solium,肥胖带绦虫(牛带绦虫)Taenia saginata,Taenia spp.adult wormThe chain of proglottids is called the strobila,and may be composed of over 1.000 proglottids.T.saginata may measure 9 m,whereas T.solium may reach 6 m.,两种带绦虫比较,猪带绦虫 牛带绦虫体长 2-4m 4-8m节片 700-1000 1-2千节头节 圆顶突小钩 方无小钩成节卵巢 3叶 2叶孕节子宫
2、7-13支 15-30支,猪带绦虫 牛带绦虫中间宿主 猪/人 牛 感染期 卵/猪囊尾蚴 牛囊尾蚴 感染形式 互相/自体感染 互相感染 引起疾病 绦虫病/囊虫病 绦虫病 诊断 粪检可查获卵肛试法 治疗 吡喹酮/槟榔-南瓜子,The scolex of T.solium,hooklets,rostullum,suckers,The scolex of T.saginata,Gravid proglottid of T.solium,Gravid proglottid of T.saginata,卵(Egg),两种带绦虫卵相似类圆形卵壳薄,易破裂壳内具有放射条纹的胚膜含六钩蚴,Taenia spp.
3、egg,囊尾蚴(cysticercus),白色囊状物内含透明囊液两层囊壁内层增厚为头节,T.solium:cysticercus cellulosae with invaginated scolex,Life cycle of Taenia solium,猪带绦虫感染期 绦虫病:口入含囊尾蚴的猪肉 囊尾蚴病:口入虫卵感染方式 自身感染:体内、体外 异体感染,Life cycle of Taenia saginata,807例囊尾蚴病,眼 46 脑 40.9%皮下 6.3%肌肉 3.5%其它 3.2%,治疗(Treatment),带绦虫病:吡喹酮首选 南瓜子槟榔疗效好(查头节考核疗效)囊尾蚴病:
4、手术摘除 阿苯达唑或吡喹酮,猪带 牛带 Parasitic site:small intestinal Infection stage:egg/cysticercusPathogenic stage:larva/adult wormEtiologic dignosis:fecal exam./perianal egg exam.Drug:Albendazole,细粒棘球绦虫,Echinococcus granulosus,概述,人兽共患寄生虫病畜牧区动物群中流行成虫寄生于犬、狼、狐等幼虫寄生于人、牛、羊等内脏引起棘球蚴病,一、形态(Morphological features),1.成虫:Mi
5、nute,4-7mm in lenght;Comprises of 4 segments scolex&cervical,immature、mature、gravid segment2.虫卵:Morphologically indis-tinguible to the Taenia egg,Adult of Echinococcus granulosus,3.棘球蚴(Hydatid cyst),Round&cystic(囊状体)Wall:角皮层(cuticle layer)、生发层(germinal layer)Contents:生发囊、原头蚴、子囊、孙囊(棘球蚴砂)、囊液,Protoscol
6、eces with double row hooklets and calcareous corpuscles,Hydatid sand,二、Life cycle,EggAdult worm Hydatid cyst(犬狼等小肠)(人羊等肝肺),污染牧草,Life-cycle feature,Infection stage:Egg(oral)Man(or take herbivorous animals):intermediate hostParasitic site(Hydatid cyst):Liver、lung or brain etc,单个寄生,可存活40年,三、致病(Pathogen
7、eses),棘球蚴病或包虫病(Echinococcosis or Hydatidosis)压迫(Pressure):肝、肺、脑功能障碍过敏(Allergy):囊液溢出,过敏休克播散再生:囊内原头蚴侵入腹腔再发,四、诊断(Diagnosis),免疫诊断+超声检查手术时取囊液查病原体(穿刺时注意防止囊液外溢),五、流行(Epidemiology),分布:森林型、畜牧型流行因素:犬粪污染牧草、水土 人犬密切接触 病畜内脏管理不善喂狗,六、防治原则(Principles of control),加强个人防护,杜绝虫卵感染处理好病畜内脏定期为牧犬治疗Surgical removal:内囊摘除术(甲醛处理
8、)Albendazole:1020mg/kg,1216周,刚地弓形虫,Toxoplasma gondii,弓形虫概述,世界性分布人畜共患寄生温血动物和猫科动物机会致病,一、Morphology 1.In intermediate hosts,(人或温血动物有核细胞内)Tachyzoite:弓形,内二芽殖,胞内繁殖(假包囊,preudocyst)Cyst:有囊壁,内含大量 缓殖子(bradyzoite),In cell cultures,T.gondii proliferates to form a pseudocyst of 8-20 parasites.,T.gondii:lysis of
9、a THP-1 cell with release of tachizoites in culture.,T.gondii:tissue cysts,100-300 m,may contain up to 3 000 bradyzoites.,Tachyzoites of Toxoplasma gondii in macrophages of mouse in peritoneal exudate.(SEM),2.In definitive host,猫科动物小肠上皮细胞内裂殖体:Asexual配子体:雌雄配子受精(sexual)卵囊(oocyst):内含2个孢子囊,各含4个子孢子,二、Lif
10、e cycle,特点:两类宿主,两种生殖方式猫科动物:definitive host-配 子生殖人或其它温血动物:intermediate host-无性生殖(包括猫科动物的非肠上皮细胞内),Oocvst(随粪排出)Sporozoite tachyzoite 合子 Gametocyte(人,动物)Schizont Cyst(猫)(Bradyzoite),生活史要点,Infection stage:oocyst,cyst,tachyzoiteInfection mode:垂直传播:胎盘(Mother Children)水平传播:口入、输血、伤口等Parasitigic site:淋巴结、脑、眼、
11、肌肉、肝、心、肺等,三、致病(Pathogenesis),1.机制Tachyzoite:细胞内增生与破坏Cyst:累及重要脏器、组织代谢物致变态反应,2.Clinical types,1)Congenital toxoplasmosis:四联症 视网膜脉络膜炎 脑积水 脑钙化 小头畸形,2)Acquired toxoplasmosis,(In immuno-competent hosts)多数无症状:90%suppressive infection少数可见:急性淋巴结炎 视网膜脉络膜炎;罕见肺炎,肝炎,心肌炎,脑膜脑炎,隐性感染激活,发病 重症型,全身性感染,预后差,2)Acquired to
12、xoplasmosis(In immuno-incompetent hosts),四、诊断(Dignosis),病原学:组织体液活检,涂片染色 动物接种分离、细胞培养、PCR测弓形虫DNA免疫学:测抗体(IgG+:有感染;IgM+:可能是新感染);测抗原,五、流行(Epidemiology),1.Epidemic factors传染源:猫、家畜和野生温血动物传播途径:Man(胎盘,输血)Man Animal(肉食品,水)Man Animal(食肉)Animal,2.Epidemic fecture,生活史多期均有传染性宿主、寄生部位要求不严格中间宿主间可相互传播组织内包囊存活长,卵囊抗力大猫为主要传染源(粪便内卵囊污染),六、防治(Control),治疗患者:Drugs:Pyrimethamine+Sulfadizines Spiramycin预防为主:no consume undercooked meat严格个人卫生及食品卫生要求孕妇防止与猫接触、产前检查,E.h.Parasitic site:intestinal wallInfection stage:4 nuclei cystPathogenic stage:trophozoiteEtiologic dignosis:stool examinationDrug:metronidazole,