旋毛蟲(chong)(chong)(chong)(chong)(chong)(chong)病(trichinosis)旋毛線(xian)蟲(chong)(chong)(chong)(chong)(chong)(chong)寄(ji)生(sheng)于人體(ti)引起(qi)的(de)(de)(de)一(yi)種人畜共患(huan)的(de)(de)(de)寄(ji)生(sheng)蟲(chong)(chong)(chong)(chong)(chong)(chong)病。假旋毛線(xian)蟲(chong)(chong)(chong)(chong)(chong)(chong)也可(ke)引起(qi)。成蟲(chong)(chong)(chong)(chong)(chong)(chong)寄(ji)生(sheng)于小腸上(shang)部(bu)的(de)(de)(de)粘膜(mo)上(shang)皮(pi)層內,雌蟲(chong)(chong)(chong)(chong)(chong)(chong)受精后(hou)產卵(luan),蟲(chong)(chong)(chong)(chong)(chong)(chong)卵(luan)在其(qi)子宮內孵化為幼(you)蟲(chong)(chong)(chong)(chong)(chong)(chong),幼(you)蟲(chong)(chong)(chong)(chong)(chong)(chong)排(pai)出后(hou)即鉆(zhan)入淋巴管或(huo)(huo)小靜脈(mo)并隨體(ti)循環到達全身各處。主(zhu)(zhu)要在橫紋肌(ji),尤(you)其(qi)是膈肌(ji)、舌(she)肌(ji)及其(qi)他活動較多的(de)(de)(de)肌(ji)肉內成囊,其(qi)囊壁由宿主(zhu)(zhu)的(de)(de)(de)組(zu)織反應(ying)形成,囊內幼(you)蟲(chong)(chong)(chong)(chong)(chong)(chong)可(ke)存(cun)活多年,但成蟲(chong)(chong)(chong)(chong)(chong)(chong)壽命僅1個(ge)月左右。鼠、豬、犬、野(ye)豬、熊等均可(ke)為貯存(cun)宿主(zhu)(zhu),人們(men)常因進食不熟的(de)(de)(de)帶蟲(chong)(chong)(chong)(chong)(chong)(chong)豬肉或(huo)(huo)其(qi)他肉而受感染。
臨床征象分(fen)為(wei)3期(qi),腸期(qi)為(wei)幼蟲在腸粘膜(mo)內發育為(wei)成蟲,此(ci)時(shi)可(ke)有(you)惡(e)心、嘔吐、腹(fu)痛及(ji)(ji)腹(fu)瀉;移行期(qi)的(de)癥狀有(you)發冷、發熱(re),體溫與感染程(cheng)度往往平(ping)行,顏(yan)面浮腫,全(quan)身肌(ji)(ji)肉腫脹和疼(teng)痛,以腓腸肌(ji)(ji)為(wei)明(ming)顯,眼肌(ji)(ji)活動受(shou)限(xian),咀(ju)嚼、吞咽、言語(yu)及(ji)(ji)呼吸困難,末梢(shao)血液(ye)酸(suan)性(xing)粒細胞數明(ming)顯增(zeng)多,也可(ke)出(chu)現(xian)心肌(ji)(ji)炎、腦炎、腦膜(mo)炎等(deng)征象,此(ci)期(qi)死亡率較高;感染后第3周幼蟲周圍開始形(xing)成包囊(nang)稱(cheng)為(wei)成囊(nang)期(qi),此(ci)時(shi)發熱(re)等(deng)癥狀逐(zhu)漸減(jian)輕,并進(jin)入恢復期(qi)。診斷(duan)(duan)主要依據吃生肉史、臨床特征及(ji)(ji)血清免(mian)疫學(xue)反(fan)應陽(yang)性(xing),肌(ji)(ji)肉活檢也有(you)助于確診;檢測循環(huan)抗原有(you)助于早期(qi)診斷(duan)(duan)及(ji)(ji)考核療效。大(da)劑量丙硫苯咪(mi)唑治療有(you)效。
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