免疫功能健全者获得性弓形虫病的研究进展

doi:10.12140/j.issn.1000-7423.2022.02.015

中国寄生虫学与寄生虫病杂志 ›› 2022, Vol. 40 ›› Issue (2): 228-235.doi: 10.12140/j.issn.1000-7423.2022.02.015

免疫功能健全者获得性弓形虫病的研究进展

赵紫琪¹(), 吕芳丽²^,³^,⁴^,^*()

1.广州中医药大学青蒿研究中心,广州 510405
2.中山大学附属第七医院检验科,深圳 518107
3.中山大学中山医学院寄生虫学教研室,广州 510080
4.中山大学热带病防治研究教育部重点实验室,广州 510080

收稿日期:2021-08-13 修回日期:2021-11-27 出版日期:2022-04-18 发布日期:2022-04-18
通讯作者: 吕芳丽
作者简介:赵紫琪（1996-）,女,硕士研究生,从事弓形虫病防治研究。E-mail： 843377801@qq.com
基金资助:
国家自然科学基金面上项目(81971955);广东省自然科学基金面上项目(2019A1515011667);广东省自然科学基金面上项目(2021A1515012115);广东省研究生教育创新计划项目(2021SFKC003);广东省科技计划项目(2021A0505030060)

Research progress on acquired toxoplasmosis in immunocompetent individuals

ZHAO Zi-qi¹(), LV Fang-li²^,³^,⁴^,^*()

1. Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
2. Department of Clinical Laboratory, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
3. Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
4. Key Laboratory of Tropical Disease of Ministry of Education, Sun Yat-sen University, Guangzhou 510080, China

Received:2021-08-13 Revised:2021-11-27 Online:2022-04-18 Published:2022-04-18
Contact: LV Fang-li
Supported by:
National Natural Science Foundation of China(81971955);Natural Science Foundation of Guangdong Province(2019A1515011667);Natural Science Foundation of Guangdong Province(2021A1515012115);Graduate Education Innovation Plan Project of Guangdong Province(2021SFKC003);Science and Technology Planning Project of Guangdong Province(2021A0505030060)

摘要/Abstract

摘要：

免疫功能健全者感染刚地弓形虫（简称弓形虫）后多数表现为无症状,但少数可出现轻微甚至严重的临床症状。笔者在PubMed和中国知网中使用关键词“免疫功能健全”“弓形虫”“弓形虫病”“诊断”和“治疗”系统检索1984—2021年报道的免疫功能健全的获得性弓形虫病病例文献,综述了免疫功能健全者获得性弓形虫病的临床表现、发病机制、诊断和治疗等方面的资料,为临床上鉴别诊断和治疗弓形虫病提供参考。

关键词: 弓形虫病, 免疫功能健全者, 诊断, 治疗

Abstract:

Although Toxoplasma gondii infection is usually asymptomatic in immunocompetent individuals, a small part of T. gondii-infected immunocompetent individuals may have mild or even severe clinical symptoms. Using the keywords “immunocompetent” “T. gondii” “toxoplasmosis” “diagnosis” and “treatment” in the PubMed and China National Knowledge Infrastructure (CNKI) search engines, the authors systematically searched the cases of acquired toxoplasmosis in immunocompetent individuals reported from 1984 to 2021. This review summarizes the clinical manifestation, pathogenesis, diagnosis, and treatment of acquired toxoplasmosis in immunocompetent individuals, to provide a reference for clinical differential diagnosis and treatment of toxoplasmosis.

Key words: Toxoplasmosis, Immunocompetent individual, Diagnosis, Treatment

中图分类号:

R531.8

赵紫琪, 吕芳丽. 免疫功能健全者获得性弓形虫病的研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(2): 228-235.

ZHAO Zi-qi, LV Fang-li. Research progress on acquired toxoplasmosis in immunocompetent individuals[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2022, 40(2): 228-235.

图/表 1

表1

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特征	病例数/例
特征	眼弓形虫病（n = 16）	肺弓形虫病（n = 11）	脑弓形虫病（n = 19）	其他弓形虫病（n = 32）
性别
男	10	6	15	23
女	6	5	4	9
流行病学史
接触猫	2	1	2	4
接触鹿、熊、犬、野兔	3	-	1	1
食用生肉、半生肉	2	8	4	11
食用鹿、犰狳、豚鼠、野猪肉	-	-	-	7
其他	9	2	12	9
临床症状
发热	2	11	8	24
淋巴结肿大	1	4	3	15
头痛、肌痛	2	8	13	21
眼睛疼痛、漂浮物	8	-	-	-
视力下降	15	-	2	3
呼吸系统症状	2	15	5	17
神经系统症状	-	-	18	4
胸闷、胸痛	-	2	-	7
心肌炎、心包炎	1	-	-	11
多发性肌炎	1	-	-	9
肝炎	-	-	-	5
肾病综合征	-	-	-	2
风疹皮疹或丘疹	-	-	1	5
面神经麻痹	-	-	2	1
附睾炎睾丸炎	-	-	-	1
弓形虫血清学检测
IgM⁺/IgG⁺	7	5	5	26
IgM^-/IgG⁺	3	-	5	-
IgM⁺/IgG^-	-	1	-	3
IgM^-/IgG^-	1	-	2	1
IgM未知/IgG⁺	2	1	3	-
IgM⁺/IgG未知	-	3	1	-
未知	3	1	3	2
弓形虫PCR检测
阳性	7	2	3	6
阴性	-	-	2	4
未知	9	9	14	22
治疗药物
PY	-	-	-	1
PY + SDZ	-	1	3	4
PY + SDZ + LKV	4	4	3	8
TMP-SMX	6	2	2	3
TMP-SMX + PY	-	-	1	-
TMP-SMX + LKV	-	-	1	-
TMP-SMX + PY + LKV	2	-	1	-
TMP-SMX + PY + SDM	-	-	-	1
TMP-SMX + PY + SDZ	-	1	-	1
TMP-SMX + PY + SDZ + LKV	3	-	1	2
SPM	-	1	-	1
SPM + PY	-	1	-	1
SPM + SDZ	-	-	1	-
SPM + PY + SDZ	-	1	-	-
SPM + PY + SDZ + LKV	-	-	1	-
Ac-SPM + PY	1	-	-	-
Ac-SPM + PY + SDZ	-	-	1	-
CS/ATB/ATB + CS	-	-	3	6
其他	-	-	1	4
预后
存活	16	11	15	31
死亡	0	0	4	1
参考文献	[12-14,46-47,51-53,71-73,85]	[15,18,48,54-56, 74,82-83]	[21-24,30,49-50, 57-59,75-81,84]	[25-32,34-41, 43,60-70,86]

免疫功能健全者获得性弓形虫病的研究进展

Research progress on acquired toxoplasmosis in immunocompetent individuals

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