日本血吸虫病课件_1.ppt

日本血吸虫病Schistosomiasis japonica;血吸虫病（Schistosomiasis）是其尾蚴经皮肤感染人或动物（多种家畜和野生动物），感染方式：接触疫水。中间宿主：钉螺。 血吸虫成虫寄生于人体静脉系统所引起的寄生虫病，虫卵是主要致病因素。 六种血吸虫有致病性，我国仅有日本血吸虫病在我国已有2000多年的历史 。 血吸虫病分布于长江中下游及其以南的12个省、市、自治区，属我国五大寄生虫病之一 ，WHO确定的六大热带病之一。 ; Epidemiology;Distribution of schistosomiasis cases in 2003;Correlation;Characteristics of schistosoma;Morphology 形态学;;9;10;寄生部位：肠系膜静脉; Pathogenesis 1; Pathogenesis 2;成虫 几乎无致病作用。少数可引起轻微的机械性损害，如静脉内膜炎。但代谢产物、虫体分泌物、排泄物等，在机体内可形成免疫复合物，对宿主产生损害,如肾小球肾炎 Adult schistosoma, not play a significant role in pathogenic events.;虫卵 是血吸虫病的主要致病阶段，致病最严重。随血流沉积于肝和结肠引起虫卵肉芽肿导致血管纤维化，是血吸虫病的主要病变。 Ova carried by portal blood embolize to the liver and intestine , granulomas are formed. Granulomas contribute to the liver enlargement and liver Fibrosis. Immunomodulation is an essential mechanism in shaping the clinical and pathologic outcome of schistosomiasis. ;Pathology;肝组织内的虫卵Eggs in the liver; Ova granuloma;肉芽肿形成机理(2) 在肝内，虫卵肉芽肿位于窦前静脉，故肝小叶的结构和功能一般不受影响。 门脉周围出现广泛的纤维化，肝切面上，围绕在门静脉周围长而白色的纤维束从不同角度插入肝内，称干线型纤维化（pipestem fibrosis），是晚期血吸虫病特征性病变。由于窦前静脉的广泛阻塞，导致门静脉高压，出现肝、脾肿大，侧支循环，腹壁、食管及胃底静脉曲张，以及上消化道出血与腹水等症状。;The granulomatous response around these ova is cell-mediated and is regulated both positively and negatively by a cascade of cytokine, cellular, and humoral responses. Granuloma formation begins with recruitment of a host of inflammatory cells in response to antigens secreted by the living organism within the ova. ;Immunity 免疫力 ; Clinic Manifestation ;Clinic Manifestation ;The late-stage patient;Heterotropic parasitism;Laboratory Findings;Laboratory Findings ;Diagnosis, Differential Diagnosis; Diagnosis;Treatment and Prevention;Drug Therapy for blood flukes Infections;Morbidity control;Case Study;47mTwo)lW2r3gU6DhcT!mB4anWxKEm!l(11sDGXoX05O7q+Ytib$2PuCIXltS9Qz3M2KW$DinstLRPtwREw(L9z$Gkq!vg(JolU-qaQDmEGaZ8gY(pC!B)qmFimb%TcNp67gV#$KISTpT0m02-SDFdi!M#01WFOuo1XdGX5AR3FxDoemIT-GRhh3yE*2qtsv9pvzSPyeNSHi5Ll5h#e6x%a6yV-nYGU$gG0R8R!LwhDK)+h!uf4gKptgx-mZq