中国棘球蚴病防诊治体系建设与创新实践

doi:10.12140/j.issn.1000-7423.2019.04.003

中国寄生虫学与寄生虫病杂志 ›› 2019, Vol. 37 ›› Issue (4): 388-394.doi: 10.12140/j.issn.1000-7423.2019.04.003

中国棘球蚴病防诊治体系建设与创新实践

阿卜杜萨拉木·艾尼^1,²(), 邵英梅^2,³, 吐尔干艾力·阿吉^2,³, 张文宝⁴, 林仁勇⁴, 侯岩岩⁵, 张壮志⁶, 温浩^1,^*()

； 1 新疆医科大学中亚高发病成因与防治国家重点实验室,乌鲁木齐 830011
2 新疆医科大学第一附属医院,消化血管外科中心肝胆包虫外科,乌鲁木齐 830011
3 新疆医科大学第一附属医院,消化血管外科中心,乌鲁木齐 830011
4 临床医学研究院,乌鲁木齐830054;乌鲁木齐 830011
5 新疆维吾尔自治区疾病预防控制中心,乌鲁木齐 830001
6 新疆畜牧科学院兽医研究所,乌鲁木齐 830011

收稿日期:2019-07-18 出版日期:2019-08-30 发布日期:2019-09-05
通讯作者: 温浩
作者简介:
作者简介：阿卜杜萨拉木·艾尼（1987-）,男,博士研究生,从事棘球蚴病及自体肝移植研究。E-mail: abdusallam925@hotmail.com
基金资助:
新疆维吾尔自治区重点实验室开放课题（No. 2017D04004,No. 2019D04021）

Establishment and innovative practice of Integrative System of Prevention, Diagnosis and Management for echinococcosis in China

Aini ABUDUSALAMU^1,²(), Ying-mei SHAO^2,³, Aji TUERGANAILI^2,³, Wen-bao ZHANG⁴, Ren-yong LIN⁴, Yan-yan HOU⁵, Zhuang-zhi ZHANG⁶, Hao WEN^1,^*()

1 State Key Laboratory of Pathogenesis, Prevention and Management of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi 830011, China
2 Department of Hepatobiliary and Hydatid Disease,Urumqi 830011, China
3 Digestive and Vascular Surgery Center,Urumqi 830011, China
4 Clinical Medical Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
5 Xinjiang Uyghur Autonomous Region Center for Disease Prevention and Control, Urumqi 830001, China
6 Veterinary Institute, Xinjiang Academy of Animal Sciences, Urumqi 830011, China

Received:2019-07-18 Online:2019-08-30 Published:2019-09-05
Contact: Hao WEN
Supported by:
Supported by Xinjiang Uyghur Autonomous Region Key Laboratory Open Research Program (No. 2017D04004, No. 2019D04021)

摘要/Abstract

摘要：

棘球蚴病（又称包虫病）是由棘球绦虫的幼虫感染所致的人兽共患寄生虫病,属于被忽视的热带病,呈全球性分布。在中国,细粒棘球蚴病和多房棘球蚴病流行情况均居全球首位,对公共卫生构成威胁并造成巨大经济损失。我国西部地区多房棘球蚴病的疾病负担占全球90%以上。自中华人民共和国成立以来,我国棘球蚴病的防治取得了巨大成就,临床治愈率得到显著提高,并发症和死亡率明显下降,人群及动物宿主的感染率降低。21世纪以来,我国在棘球绦虫的遗传学、基因组学、分子流行病学和免疫学,棘球蚴病的诊断措施、治疗技术、防控策略以及疫苗研发等方面取得了鼓舞人心的成就。本文着重提出并阐述棘球蚴病防诊治体系的建设与创新实践,主要包括：科学防控体系、规范诊断体系、创新术式与药物治疗体系以及创新研究与转化应用。

关键词: 棘球蚴病, 科学防控, 规范诊断, 创新术式, 药物治疗, 研究与转化

Abstract:

Echinococcosis (hydatid disease) is a neglected tropical zoonotic disease caused by the infection of Echinococcus larvae. It prevails globally and China has the highest disease burden of two main types of echinococcosis including cystic echinococcosis (CE) and alveolar echinococcosis (AE). The hydatid disease is a big threat of public health and a heavy burden of economic lose in China. The AE cases in western China account for over 90% of the total AE cases in the world. Great achievements have been made in the control and treatment of the diseases since the founding of People’s Republic of China, including remarkable improvement in clinical cure rate, significant reduction in morbidity and mortality in humans and infections in animals. China has made inspiring achievements in the research of the genomics, molecular epidemiology, immunology, diagnostic tools, treatment approaches, prevention strategies and vaccine development of echinococcosis especially since the beginning of the 21th century. This paper mainly described and discussed the establishment and innovative practice of Integrative System of Prevention, Diagnosis and Management for echinococcosis in China, which includes systems for scientific prevention and control, standardized diagnosis, innovative surgery and treatment, and relevant research and translational application.

Key words: Echinococcosis, Scientific prevention, Standardized diagnosis, Innovative surgery, Medication, Research and translation

中图分类号:

R532.32

阿卜杜萨拉木·艾尼, 邵英梅, 吐尔干艾力·阿吉, 张文宝, 林仁勇, 侯岩岩, 张壮志, 温浩. 中国棘球蚴病防诊治体系建设与创新实践[J]. 中国寄生虫学与寄生虫病杂志, 2019, 37(4): 388-394.

Aini ABUDUSALAMU, Ying-mei SHAO, Aji TUERGANAILI, Wen-bao ZHANG, Ren-yong LIN, Yan-yan HOU, Zhuang-zhi ZHANG, Hao WEN. Establishment and innovative practice of Integrative System of Prevention, Diagnosis and Management for echinococcosis in China[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2019, 37(4): 388-394.

图/表 3

参考文献 36

[1]	Deplazes P, Rinaldi L, Alvarez Rojas CA, et al. Global distribution of alveolar and cystic echinococcosis[J]. Adv Parasitol, 2017, 95: 315-493.
[2]	中国医师协会外科医师分会包虫病外科专业委员会. 肝两型包虫病诊断与治疗专家共识(2019版)[J]. 中华消化外科杂志, 2019, 18(8): 711-721.
[3]	Wen H, Vuitton L, Tuxun T, et al. Echinococcosis: advances in the 21st century[J]. Clin Microbiol Rev, 2019, 32(2): e00075-e00018.
[4]	Torgerson PR, Schweiger A, Deplazes P,et al. Alveolar echinococcosis: from a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years[J]. J Hepatol, 2008, 49(1): 72-77.
[5]	Brunetti E, Kern P, Vuitton DA, et al. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans[J]. Acta Trop, 2010, 114(1): 1-16.
[6]	伍卫平, 王虎, 王谦, 等. 2012-2016年中国棘球蚴病抽样调查分析[J]. 中国寄生虫学与寄生虫病杂志, 2018, 36(1): 1-14.
[7]	段新宇, 魏晶晶, 王乐, 等. 新疆基层医院包虫病住院患者直接经济负担分析[J]. 实用预防医学, 2015, 22(10): 1164-1166.
[8]	祖丽菲耶·艾则孜. 自体肝移植治疗终末期肝泡型包虫病患者疾病经济负担研究[D]. 乌鲁木齐: 新疆医科大学, 2017.
[9]	李军, 郭刚, 张壮志, 等. 棘球绦虫的主要生理学特点与包虫病控制方法的确立[J]. 中华预防医学杂志, 2018, 52(2): 210-214.
[10]	Anderson FL, Chai JJ, Liu FJ.Prevalence of Echinococcus granulosus in dogs in the Xinjiang Uygur Autonomous Region, Prc. Compendium on cystic echinococcosis with special reference to the Xinjiang Uygur Autonomous Region, People’s Republic of China[M]. Utah: Bringham Young University print service, 1993: 5-7.
[11]	王国强. 全国包虫病流行情况调查报告[M]. 上海: 上海科学技术出版社, 2016: 17.
[12]	Jenkins DJ.WHO/OIE manual on echinococcosis in humans and animals: a public health problem of global concern[J]. Int J Parasitol, 2001, 31(14): 1717-1718.
[13]	McManus DP, Gray DJ, Zhang WB, et al. Diagnosis, treatment, and management of echinococcosis[J]. BMJ, 2012, 344: e3866.
[14]	Kern P.Clinical features and treatment of alveolar echinococcosis[J]. Curr Opin Infect Dis, 2010, 23(5): 505-512.
[15]	Stojković M, Weber TF, Junghanss T.Clinical management of cystic echinococcosis: state of the art and perspectives[J]. Curr Opin Infect Dis, 2018, 31(5): 383-392.
[16]	Brumpt E, Blagosklonov O, Calame P, et al. AE hepatic lesions: correlation between calcifications at CT and FDG-PET/CT metabolic activity[J]. Infection, 2019, DOI:10.1007/s15010-019-01328-z.
[17]	Ahn CS, Han XM, Bae YA, et al. Alteration of immunoproteome profile of Echinococcus granulosus hydatid fluid with progression of cystic echinococcosis[J]. Parasit Vectors, 2015, 8: 10.
[18]	Zeghir-Bouteldja R, Polomé A, Bousbata S, et al. Comparative proteome profiling of hydatid fluid from Algerian patients reveals cyst location-related variation in Echinococcus granulosus[J]. Acta Trop, 2017, 171: 199-206.
[19]	Hernández-González A, Santivañez S, García HH, et al. Improved serodiagnosis of cystic echinococcosis using the new recombinant 2B2t antigen[J]. PLoS Negl Trop Dis, 2012, 6(7): e1714.
[20]	Vuitton DA, Gottstein B.Echinococcus multilocularis and its intermediate host: a model of parasite-host interplay[J]. J Biomed Biotechnol, 2010, 2010: 923193.
[21]	Valot B, Rognon B, Prenel A, et al. Screening of antigenic vesicular fluid proteins of Echinococcus multilocularis as potential viability biomarkers to monitor drug response in alveolar echinococcosis patients[J]. Proteomics Clin Appl, 2017, 11(11/12).
[22]	Knapp J, Umhang G, Poulle ML, et al. Development of a real-time PCR for a sensitive one-step coprodiagnosis allowing both the identification of carnivore feces and the detection of Toxocara spp. and Echinococcus multilocularis[J]. Appl Environ Microbiol, 2016, 82(10): 2950-2958.
[23]	Aliakbarian M, Tohidinezhad F, Eslami S, et al. Liver transplantation for hepatic alveolar echinococcosis: literature review and three new cases[J]. Infect Dis (Lond), 2018, 50(6): 452-459.
[24]	Piarroux M, Piarroux R, Giorgi R, et al. Clinical features and evolution of alveolar echinococcosis in France from 1982 to 2007: results of a survey in 387 patients[J]. J Hepatol, 2011, 55(5): 1025-1033.
[25]	Koch S, Bresson-Hadni S, Miguet JP, et al. Experience of liver transplantation for incurable alveolar echinococcosis: a 45-case European collaborative report[J]. Transplantation, 2003, 75(6): 856-863.
[26]	Bresson-Hadni S, Blagosklonov O, Knapp J, et al. Should possible recurrence of disease contraindicate liver transplantation in patients with end-stage alveolar echinococcosis? A 20-year follow-up study[J]. Liver Transpl, 2011, 17(7): 855-865.
[27]	Pichlmayr R, Bretschneider HJ, Kirchner E, et al. Ex situ operation on the liver. A new possibility in liver surgery[J]. Langenbecks Arch Chir, 1988, 373(2): 122-126.
[28]	Wen H, Dong JH, Zhang JH, et al. Ex vivo liver resection followed by autotransplantation for end-stage hepatic alveolar echinococcosis[J]. Chin Med J, 2011, 124(18): 2813-2817.
[29]	温浩, 董家鸿, 张金辉, 等. 体外肝切除联合自体肝移植治疗肝泡型包虫病[J]. 中华消化外科杂志, 2011, 10(2): 148-149.
[30]	季学闻, 张金辉, 于湘友, 等. 自体肝移植治疗终末期肝泡型包虫病一例[J]. 中华消化外科杂志, 2015, 14(2): 157-158.
[31]	Wen H, Dong JH, Zhang JH, et al. Ex vivo liver resection and autotransplantation for end-stage alveolar echinococcosis: a case series[J]. Am J Transplant, 2016, 16(2): 615-624.
[32]	吐尔干艾力·阿吉, 邵英梅, 赵晋明, 等. 肝泡型包虫病自体肝移植中提升功能肝“量与质”的临床实践: 附12例临床病例分析[J]. 中华医学杂志, 2017, 97(4): 270-275.
[33]	Aji T, Dong JH, Shao YM, et al. Ex vivo liver resection and autotransplantation as alternative to allotransplantation for end-stage hepatic alveolar echinococcosis[J]. J Hepatol, 2018, 69(5): 1037-1046.
[34]	Kern P, Wen H, Sato N, et al. WHO classification of alveolar echinococcosis: principles and application[J]. Parasitol Int, 2006, 55(Suppl): S283-S287.
[35]	Wang J, Jebbawi F, Bellanger AP, et al. Immunotherapy of alveolar echinococcosis via PD-1/PD-L1 immune checkpoint blockade in mice[J]. Parasite Immunol, 2018, 40(12): e12596.
[36]	Zhang C, Lin R, Li Z, et al.Immune exhaustion of T cells in alveolar echinococcosis patients and its reversal by blocking checkpoint receptor TIGIT in a murine model[J]. Hepatology, 2019, DOI:10.1002/hep.30896.

中国棘球蚴病防诊治体系建设与创新实践

Establishment and innovative practice of Integrative System of Prevention, Diagnosis and Management for echinococcosis in China

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 3

参考文献 36

相关文章 15

编辑推荐

Metrics

本文评价

[1]	李奔福, 杨敬, 杨金玉, 罗瑞娟, 朱斌林, 陈泰林, 张丽娟, 李雪瑶, 严信留, 字金荣, 彭佳, 王正青, 李健雄, 蔡璇, 徐倩, 吴方伟, 杨亚明. 云南省大理州棘球蚴病流行病学调查和病例回顾性分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(5): 573-578.
[2]	倪碧娴, 徐祥珍, 张强, 唐凤, 张嘉尧, 茅范贞, 戴洋, 刘耀宝, 曹俊. 2015—2022年江苏省棘球蚴病网络报告病例流行病学特征分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(5): 636-639.
[3]	封晓晓, 白玛央金, 张颋, 陆豪杰, 魏黎明. 血清IgG唾液酸化修饰在肝棘球蚴病诊断中的应用研究[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(4): 434-439.
[4]	朱爱娅, 王旭, 王江友, 王颖, 李杨, 宋珊, 耿燕, 兰子尧, 戴佳芮. 贵州省儿童多房棘球蚴病1例[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(4): 520-523.
[5]	娆琬·托勒洪, 阿不都撒拉木·阿不力克木, 杨凌菲, 陈璐, 李钊, 贾芳, 宋涛. 超声表现诊断肝多房棘球蚴病的效果评价及因素分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(3): 312-318.
[6]	王威, 蔡辉霞. 2020年青海省棘球蚴病监测结果[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(3): 319-324.
[7]	蒉嫣, 薛垂召, 王旭, 刘白雪, 王莹, 王立英, 杨诗杰, 韩帅, 伍卫平, 肖宁. 2021年全国棘球蚴病防治进展[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 142-148.
[8]	马冰村, 刘玉英, 张甜甜, 雷雯, 马霄, 刘寿. 青海省棘球蚴病影响因素的病例对照研究[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 183-191.
[9]	马慧, 种世桂, 陈根, 张伶慧, 秦俊梅, 赵玉敏. 多房棘球蚴病相关细胞信号通路的研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 223-227.
[10]	路伟民, 杨小涛, 朱瑛, 张鸿, 李霁伟, 王艳春. 儿童肺细粒棘球蚴病1例[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 253-256.
[11]	曹得萍, 毋德芳, 庞明泉, 彭小红, 李大宇, 樊海宁. 棘球蚴病患者肠道菌群差异性分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(1): 103-107.
[12]	段红菊, 李凌杰, 吴向林, 闫芳, 齐蓉婷, 马天波. 2016—2021年宁夏细粒棘球蚴病手术患者住院费用及其影响因素分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(1): 75-80.
[13]	吴向林, 闫芳, 段红菊, 齐蓉婷, 马天波, 高建炜. 2021年宁夏多房棘球蚴病流行区犬和野外宿主感染情况[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(6): 717-722.
[14]	刘玉英, 张甜甜, 马霄, 雷雯, 马冰村, 刘寿. 青海省成年人棘球蚴病防治知识知晓情况及影响因素分析[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(6): 723-729.
[15]	安秀青, 王苗苗, 周鸿乾, 孟凯, 蔡剑平, 刘光辉, 阿吉德, 杨金煜. 肝多房棘球蚴病微血管密度的研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(6): 792-797.