Tungtrongchitr Anchalee, Manatsathit Sathaporn, Kositchaiwat Chomsri, Ongrotchanakun Jeerawan, Munkong Nantiya, Chinabutr Pisith, Leelakusolvong Somchai, Chaicumpa Wanpen
Department of Parasitology, Faculty of Medicine at Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 2004 Sep;35(3):705-10.
Irritable bowel syndrome (IBS) is a functional bowel disorder in which abdominal pain is associated with a defect or a change in bowel habits. Subtle inflammation, especially after infectious enteritis, has been sometimes suspected as one mechanism of pathogenesis. This research was performed (1) to evaluate the prevalence of parasitic infections and (2) the possible association of IBS and parasitic infections. Fifty-nine IBS patients were recruited using symptom-based criteria (Rome Criteria II) with an absence of intestinal parasitic infection by direct smear method. Stool samples of individual patients were examined using 7 methods, ie examination for stool occult blood, simple saline smear method, formalin-ether technique, culture for Blastocystis hominis, modified trichrome stain, modified Ziehl-Neelsen method, and trichrome stain for parasitic and bacterial infections. Of the 59 patients, stool samples of 13 patients (22.1%) were positive for parasites. These were B. hominis (13.6%), Strongyloides stercoralis larvae (1.7%), Giardia lamblia cysts (1.7%), and non-pathogenic protozoa, ie Endolimax nana cysts (5.1%). The prevalence rate of parasitic infections in the control group (20%) was not statistically different from the patients. There was no statistical difference between B. hominis infection in IBS patients and control was found in this study (p = 0.87). In the IBS group, B. hominis infection predominated (13.6%), while other parasitic infections were found in 8.5%. The culture method for B. hominis is more sensitive than the direct (simple) stool smear method, which is the routine diagnostic method in most laboratories. These results were also found in control group.
肠易激综合征（IBS）是一种功能性肠道疾病，腹痛与排便习惯的缺陷或改变相关。有时怀疑细微炎症，尤其是感染性肠炎后发生的炎症，是发病机制之一。本研究旨在（1）评估寄生虫感染的患病率，以及（2）IBS与寄生虫感染之间可能存在的关联。采用基于症状的标准（罗马标准II）招募了59例IBS患者，通过直接涂片法确定无肠道寄生虫感染。对每位患者的粪便样本采用7种方法进行检测，即粪便潜血检查、简单盐水涂片法、福尔马林-乙醚技术、人芽囊原虫培养、改良三色染色法、改良齐-尼氏法以及用于寄生虫和细菌感染的三色染色法。59例患者中，13例（22.1%）患者的粪便样本寄生虫检测呈阳性。这些寄生虫为：人芽囊原虫（13.6%）、粪类圆线虫幼虫（1.7%）、蓝氏贾第鞭毛虫包囊（1.7%）以及非致病性原虫，即微小内蜒阿米巴包囊（5.1%）。对照组寄生虫感染的患病率（20%）与患者组无统计学差异。本研究中，IBS患者与人芽囊原虫感染和对照组之间未发现统计学差异（p = ０.87）。在IBS组中，人芽囊原虫感染占主导（13.6%），而其他寄生虫感染占8.5%。人芽囊原虫的培养方法比直接（简单）粪便涂片法更敏感，而直接涂片法是大多数实验室的常规诊断方法。对照组也得到了同样的结果。
