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目的分析福建省广州管圆线虫病的流行病史及临床特征,为诊断与防控提供依据。方法收集全省各县(市、区)医疗机构诊治的病例资料,对其病史、临床表现、实验室检查等进行分析。结果福建省2001—2012年共诊治广州管圆线虫病58例,其中暴发流行占51.7%,散发48.3%。患者以学生为主(41.4%);地区分布:福州占77.6%,为闽南15.5%,闽东、闽北各2例。患者均有食用大瓶螺、褐云玛瑙螺、铜锈环棱螺、蛞蝓和青蛙等病史。潜伏期平均7d,主要症状为头痛、颈强、呕吐等。诊断:外周血嗜酸性粒细胞升高,3例脑脊液中检出第3期幼虫,广州管圆线虫血清抗体阳性率97.4%(37/38)。误诊率58.6%,平均15d。确诊后经阿苯哒唑治疗均治愈。结论福建省广州管圆线虫感染的病例,主要为食生或未煮熟的螺类引起。应把好“病从口入”关,加强食品卫生监督,阻断传播途径。
Objective To analyze the epidemiological history and clinical characteristics of angiostrongylus nematodes in Guangzhou, Fujian Province, and to provide basis for diagnosis and prevention. Methods Collection and treatment of cases in medical institutions in all counties (cities, districts) of the province were analyzed, and their medical history, clinical manifestations and laboratory tests were analyzed. Results In 2001-2012, 58 cases of angiostrongyliasis were diagnosed and treated in Fujian Province, among which 51.7% were outbreaks and 48.3% were distributed. The majority of patients were students (41.4%). The distribution was: Fuzhou accounted for 77.6%, accounting for 15.5% of Minnan, Fujian and Minbei respectively. Patients have consumption of big bottle snail, brown cloud agate snail, copper rust ring snail, snakehead and frog and other medical history. The average incubation period of 7d, the main symptoms of headache, neck stiffness, vomiting and so on. Diagnosis: Peripheral blood eosinophils were elevated. The third larva was detected in 3 cases of cerebrospinal fluid. The positive rate of Serum antibodies to C. elegans was 97.4% (37/38). Misdiagnosis rate of 58.6%, an average of 15d. After diagnosis of albendazole treatment were cured. Conclusions The cases of A. cantonensis in Fujian Province are mainly caused by eating or uncooked snails. Should be good “disease from the mouth ” off, strengthen food hygiene supervision, blocking the transmission.