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山东省 1997-2015 年神经囊虫病的大样本病例系列研究。

A Large Cohort of Neurocysticercosis in Shandong Province, Eastern China, 1997-2015.

机构信息

World Health Organization Collaborating Centre for Lymphatic Filariasis and Taeniasis/Cysticercosis, Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining, Shandong Province, China.

出版信息

Vector Borne Zoonotic Dis. 2019 Dec;19(12):901-907. doi: 10.1089/vbz.2019.2447. Epub 2019 Jul 17.

Abstract

Neurocysticercosis (NCC) has a wide spectrum of neurologic and psychiatric manifestations, including epileptic seizures, high intracranial pressure, cognitive dysfunction, and meningoencephalitis. This study presents the clinical diagnosis of 2539 NCC patients in Shandong Province, Eastern China, from 1997 to 2015. The diagnosis was based primarily on clinical features, neuroimaging, immunology, and electroencephalogramy studies. In all age groups, seizures were found to be the most common manifestation, followed by headaches, memory loss, and limb numbness, and disability. After antiparasitic treatment, computed tomography and magnetic resonance imaging showed that most of the lesions had been completely absorbed in 2106 (82.95%) patients, most of the lesions had been absorbed and a small proportion was converted into calcifications in 433 (17.05%) cases. Indirect hemagglutination (IHA), enzyme-linked immunosorbent assay (ELISA), and circulating antigen (CAg) serum tests initially gave 76.45%, 86.37%, and 80.66% positive results, respectively. After antiparasitic therapy, the positive rates of the IHA, ELISA, and CAg tests were 74.77%, 84.70%, and 3.75%, respectively, showing no significant difference in antibody levels ( > 0.05), but a significant difference in CAg levels ( < 0.01). The clinical antiparasitic treatment of NCC with three to four courses of a combination of albendazole and praziquantel achieved satisfactory therapeutic efficacy.

摘要

脑囊虫病(NCC)具有广泛的神经和精神表现,包括癫痫发作、颅内压升高、认知功能障碍和脑膜脑炎。本研究报告了 1997 年至 2015 年期间中国东部山东省 2539 例 NCC 患者的临床诊断。诊断主要基于临床特征、神经影像学、免疫学和脑电图研究。在所有年龄组中,癫痫发作是最常见的表现,其次是头痛、记忆力减退、肢体麻木和残疾。抗寄生虫治疗后,计算机断层扫描和磁共振成像显示,2106 例(82.95%)患者的大部分病变已完全吸收,433 例(17.05%)患者的大部分病变已吸收,一小部分病变转化为钙化。间接血凝试验(IHA)、酶联免疫吸附试验(ELISA)和循环抗原(CAg)血清检测最初分别给出了 76.45%、86.37%和 80.66%的阳性结果。抗寄生虫治疗后,IHA、ELISA 和 CAg 检测的阳性率分别为 74.77%、84.70%和 3.75%,抗体水平无显著差异(>0.05),但 CAg 水平有显著差异(<0.01)。用阿苯达唑和吡喹酮联合三到四个疗程的临床抗寄生虫治疗对 NCC 取得了令人满意的疗效。

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