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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Paragonimus,westermani,Paragonimus,westernani,was first described from two Bengal tiger that had died in zoos in Europe in 1878.During the next 2 years, infections by this worm in humans were found in,Furmosa,. It was very quickly found in the,lungs,brain,and,viscera of humans in Japan, Korea, and the Philippines. The life cycle was worked out by Kobayashi and,Yokagawa,. The major focus of infection today remains in the Orient, including India and the Philippines. It also appears to be endemic throughout the East Indies, New Guinea, the Solomon Islands, Samoa, western Africa, Peru, Colombia, and Venezuela. The taxonomy of the genus is difficult, and some of these reports may be of other, closely related species.,Paragonimiasis,is an excellent example of,zoonosis,.,并殖吸虫,Paragonimus westermani,卫氏并殖吸虫,Pag,umogonimus,skrjabini,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）,Paragonimus westermani,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,中等大小,不规则椭圆形,金黄色,1,个卵细胞、,10,多个卵黄细胞,卵壳厚薄不一,卵盖大、常倾斜、,也可缺如,大小,形状,颜色,卵壳,内容物,其他,虫卵,卵细胞,卵盖,卵壳,卵黄细胞,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,Life cycle,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,The early, invasion stages of,paragonimiasis,cause few or no symptomatic pathological conditions. Once in a lung or an ectopic site, the worm stimulates connective tissue proliferation that eventually will enshroud it in a brownish or bluish capsule. Such capsules often ulcerate and heal slowly. Eggs in surrounding tissues will themselves become centers of,pseudotubercles,. Worms in the spinal cord are known to cause paralysis, which sometimes is total. Fatal cases of,Paragonimus,in the heart have been recorded. Cerebral cases have the same results as those of cerebral,cysticercosis,. Pulmonary cases usually cause chest symptoms ,with breathing difficulties, chronic cough, and sputum containing blood or brownish streaks. Fatal cases are common.,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,录像,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,(,Endemity,and Prevention),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,1,2,3,传染源,卵巢,子宫,睾丸,卵 黄 腺,一、形态,成虫,斯氏狸殖吸虫,Pagumogonimus,skrjabini,卫氏并殖吸虫,第一中间宿主,川卷螺,斯氏狸殖吸虫,拟钉螺,终宿主,人，犬，虎,果子狸,幼虫移行症,第十一章,绦 虫,(Cestode),第一节,概论,P131,2,、虫体分节,3,、雌雄同体；,4,、无消化系统，靠体壁吸收营养。,1,、外形：,头节：,颈部：,链体：,形态,(morphology),有固着器官,(,吸盘、吸槽,),生长节,幼节,成节,孕节,细长如带、乳白色、背腹扁平、对称；,共同特征,成虫,前进,(immature proglottid),(mature proglottid),(gravid proglottid),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：,Cyclophyllidea,Pseudophyllidea,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,成节,假叶目,成节,圆叶目,孕节,假叶目,孕节,幼虫,中绦期,绦虫在中间宿主体内发育的阶段,(metacestode),囊尾蚴,(cysticercus),原尾蚴,(procercoid),裂头蚴,(plerocercoid),圆叶目,虫卵,假叶目,虫卵,虫卵,(,曼氏迭宫绦虫,),Spirometra,mansoni,adult Morphology,P,123,About 60-100 centimeter,About 100,proglottids,Scolex,of,Spirometra,mansoni,:,finger-shaped with,each,bothrium,on the dorsal and ventral surface .,bothrium,plerocercoid,(,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,Life cycle,眼裂头蚴病,皮下裂头蚴病,脑裂头蚴病,内脏裂头蚴病,Adult worms,occasional,ly reside in humans.,Pathogenesis,活组织检查,免疫学诊断,CT,、磁共振等,Diagnosis of,sparganosis,Epidemiology,source of infection,susceptible population,mode of transmission,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,How infect humans sparganosis?,吡喹酮,手术摘除,Prevention and control,肥胖带绦虫,(,Taenia solium,),（,Taenia,saginata,）,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,(life cycle),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,Infective stage,Diagnostic stage,Oncospheres,hatch,penetrate intestinal,wall,and,circulate to musculature,Oncospheres,develop into,cysticerci,in muscle,Humans infected by ingesting raw or undercooked infected meat,Eggs or gravid,proglottids,in feces and passed into environment,Scolex,attaches,to intestine,Adults in small intestine,T.saginata,T.solium,Cattle and pigs become infected by ingesting vegetation contaminated by eggs or gravid,proglottids,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,（,Prevention and care),手术摘除,细粒棘球绦虫（包生绦虫）,Echinococcus,granulosus,Morphology,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,Life cycle,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,旋毛虫,D,曼氏迭宫绦虫,E,血吸虫,5,、经皮肤感染的寄生虫可有：,血吸虫,丝虫,曼氏迭宫绦虫,蛲虫,钩虫,6,、能侵入人脑的寄生虫有：,肺吸虫童虫,血吸虫卵,猪囊尾蚴,旋毛虫,曼氏迭宫绦虫裂头蚴,7,、主要通过粪检查虫卵的寄生虫有：,血吸虫,斯氏狸殖吸虫,姜片虫,蛲虫,牛带绦虫,8,、可引起皮下结节的寄生虫发育阶段：,血吸虫成虫,曼氏迭宫绦虫裂头蚴,猪带绦虫成虫,肺吸虫童虫,牛带绦虫囊尾蚴,
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