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目的:通过对1995—1996年期间进行的新疆和布克赛尔县人囊型包虫病(CE)流行病学调查结果的随访,了解人类感染CE的自然史。方法:运用超声及血清学方法对经前期筛查确诊的51例患者,包括CE手术治疗者20例、经皮穿刺引流术(PAIR)治疗者4例、确诊CE未接受治疗者6例、超声可疑阳性者5例、肝脏孤立钙化灶8例、有既往手术史而超声未见异常者4例和超声未见异常而血清学阳性者4例,随访1～8年。结果:30例确诊CE患者中,6例未治疗者,1例4年后自发性治愈,另1例1年后随访由内囊塌陷型(CE3)转变为多子囊型(CE2);20例手术治疗者,2例4年后复发,5例持续为包虫残腔;4例PAIR治疗者,2例复发。大多数CE患者特异性IgG抗体水平呈持续阳性,但在CE术后治疗有效者中呈下降趋势,而在PAIR治疗组及术后复发者中呈上升趋势。结论:治疗后及未治疗的包虫囊肿显示了多样的病理过程。血清IgG抗体水平对临床意义不大。
OBJECTIVE: To understand the natural history of human infection of CE by follow-up of the epidemiological survey of human cystic echinococcosis (CE) in Xinjiang and Buxel, which occurred during 1995-1996. Methods: Totally 51 patients diagnosed by premenstrual screening including 20 cases of CE, 4 cases of percutaneous drainage (PAIR), 6 cases of non-CE diagnosed by CEUS and serological methods, 5 cases of suspicious positive, isolated calcification in liver in 8 cases, there was no history of previous surgery and no abnormalities in ultrasound in 4 cases and no abnormalities in ultrasound and serological positive in 4 cases, followed up for 1 to 8 years. Results: Of the 30 patients diagnosed with CE, 6 were untreated, 1 was spontaneously cured after 4 years, and the other 1 patient was followed up from CE3 to CE2 one year later; 20 patients Surgical treatment, 2 patients relapsed 4 years later, 5 cases continued hydatid disease; 4 cases of PAIR treatment, 2 cases of recurrence. The majority of CE patients with specific IgG antibody levels continued to be positive, but the CE-treated patients showed a declining trend, while the PAIR-treated patients and postoperative recurrence showed an upward trend. Conclusions: Hydatid cysts after treatment and untreated show various pathological processes. Serum IgG antibody level is of little clinical significance.