| 余康,徐卡娅.脑型肺吸虫合并肝吸虫感染1例[J].安徽医药,待发表. |
| 脑型肺吸虫合并肝吸虫感染1例 |
|
| 投稿时间：2026-06-06 录用日期：2026-07-15 |
| DOI： |
| 中文关键词: 脑型肺吸虫 肝吸虫 脑出血 阿苯达唑 嗜酸性粒细胞 |
| 英文关键词: |
| 基金项目:贵州省基础研究计划（自然科学类）（黔科合基础-ZK[2023]重点039）、贵州省科技计划项目（F-2025-96） |
|
| 摘要点击次数: 119 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的：探讨脑型肺吸虫病合并肝吸虫感染病人的临床表现、诊断、治疗过
程及发病机制。
方法：总结贵州医科大学附属医院神经外科收治的1例脑型肺吸虫病合并肝吸虫感染病人的病历资料。
结果：患者，男，25岁。因突发头痛伴意识障碍入院，初步诊断为左侧颞枕叶脑出血后行手术治疗，术后病理学检查证实病灶内存在大量嗜酸性粒细胞浸润并伴有特征性的血管袖套样改变。血清学检测提示卫氏并殖吸虫和肝吸虫抗体均呈阳性，初始给予吡喹酮驱虫治疗后，其嗜酸性粒细胞计数及占比未能恢复正常，外周血嗜酸性粒细胞计数出现非预期的平台期。考虑合并肝吸虫感染后予以联合应用阿苯达唑。后外周血嗜酸性粒细胞计数恢复正常，最终实现临床康复。
结论：本病例表明，在寄生虫病流行地区，对于肺吸虫感染且常规驱虫治疗效果不佳的患者，临床医生应高度警惕合并肝吸虫感染的可能性。同时，动态监测外周血嗜酸性粒细胞计数变化，是在医疗资源有限地区评估驱虫疗效、指导治疗方案调整的一种经济且实用的临床工具。 |
| 英文摘要: |
| Objective: To investigate the clinical manifestations, diagnosis, treatment process, and pathogenesis of a patient with cerebral paragonimiasis co-infected with Clonorchis sinensis.
Methods: The clinical data of one patient with cerebral paragonimiasis co-infected with Clonorchis sinensis, admitted to the Department of Neurosurgery, Affiliated Hospital of Guizhou Medical University, were retrospectively summarized.
Results: The patient, a 25-year-old male, was admitted due to a sudden headache accompanied by consciousness disturbance. He was initially diagnosed with left temporo-occipital cerebral hemorrhage and underwent surgical treatment. Postoperative pathological examination confirmed massive eosinophilic infiltration within the lesion, accompanied by characteristic perivascular cuffing. Serological tests indicated positive antibodies for both Paragonimus westermani and Clonorchis sinensis. After initial anthelmintic treatment with praziquantel, his eosinophil count and percentage failed to return to normal, and the peripheral blood eosinophil count exhibited an unexpected plateau. Considering the co-infection with Clonorchis sinensis, the anthelmintic regimen was adjusted to a combined application of albendazole. Subsequently, the peripheral blood eosinophil count rapidly normalized, ultimately achieving clinical recovery.
Conclusions: This case demonstrates that in parasite-endemic areas, clinicians should be highly vigilant regarding the possibility of Clonorchis sinensis co-infection in patients with Paragonimus infection who respond poorly to conventional anthelmintic treatment. Simultaneously, dynamic monitoring of peripheral blood eosinophil counts serves as a cost-effective and practical clinical tool for evaluating anthelmintic efficacy and guiding treatment regimen adjustments in resource-limited settings. |
|
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
