天门市长期住院患者人芽囊原虫感染情况分析

doi:10.12140/j.issn.1000-7423.2023.01.020

中国寄生虫学与寄生虫病杂志 ›› 2023, Vol. 41 ›› Issue (1): 121-124.doi: 10.12140/j.issn.1000-7423.2023.01.020

天门市长期住院患者人芽囊原虫感染情况分析

朱名超¹(), 朱娅²^,^*(), 赵建忠³, 原慧真⁴

1.天门市第一人民医院检验科，湖北天门 431700
2.天门市第一人民医院神经内科，湖北天门 431700
3.襄阳市第一人民医院检验科，湖北襄阳 441000
4.河南农业大学动物医学院，郑州 450046

收稿日期:2022-05-05 修回日期:2022-06-16 出版日期:2023-02-28 发布日期:2023-02-27
通讯作者: * 朱娅（1989-），女，本科，主管护师，从事神经内科护理管理工作。E-mail：15926060217@163.com
作者简介:朱名超（1989-），男，硕士，主管技师，从事病原生物学诊断及寄生虫病防治研究。E-mail：zhumingchao.412@163.com
基金资助:
武汉大学中央高校基本科研业务费专项资金(2042020kfxg05)

Analysis of Blastocystis hominis infection in long-term hospitalized patients in Tianmen City

ZHU Mingchao¹(), ZHU Ya²^,^*(), ZHAO Jianzhong³, YUAN Huizhen⁴

1. Department of Clinical Laboratory, the First people’s Hospital of Tianmen, Tianmen 431700, Hubei, China
2. Department of Neurology, the First people’s Hospital of Tianmen, Tianmen 431700, Hubei, China
3. Department of Clinical Laboratory, the First people’s Hospital of Xiangyang, Xiangyang 441000, Hubei, China
4. College of Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China

Received:2022-05-05 Revised:2022-06-16 Online:2023-02-28 Published:2023-02-27
Contact: * E-mail: 15926060217@163.com
Supported by:
Fundamental Research Funds for Central Universities of Wuhan University(2042020kfxg05)

摘要/Abstract

摘要：

2021年6—9月收集天门市第一人民医院长期住院患者基本信息（性别、年龄、粪便性状、隐血试验结果、临床症状体征等），采集患者粪样，以生理盐水直接涂片法置显微镜下检查，对疑似人芽囊原虫阳性粪样提取DNA，使用人芽囊原虫特异引物BhRDr和RD5扩增目的条带，阳性粪样送至北京诺赛基因组研究中心有限公司进行测序。患者粪样同时观察蓝氏贾第鞭毛虫和脆弱双核阿米巴感染情况。采集患者抗凝全血和非抗凝静脉血进行血液分析。857例患者中共检出人芽囊原虫阳性粪样42例，阳性检出率为4.90％，其中男性4.27%（19/445），女性5.58%（23/412），性别间阳性率差异无统计学意义（χ² = 0.791，P > 0.05）。不同年龄组中，≥ 61岁组阳性率最高（6.38%，22/345）；不同年龄间阳性检出率差异无统计学意义（χ² = 2.700，P > 0.05）。不同的粪样性状中，以稀便检出阳性率最高（18.37%，27/147）（χ² = 98.930，P < 0.05）。隐血试验便血者检出率为6.72%（9/134），未便血者为4.56%（33/723），阳性检出率差异无统计学意义（χ² = 1.123，P > 0.05）。不同临床症状中以“腹痛且腹泻”阳性率最高（4/11）（χ² = 53.956，P < 0.05）。患者中检出人芽囊原虫混合蓝氏贾第鞭毛虫感染者6例，混合脆弱双核阿米巴原虫感染者2例。人芽囊原虫感染者红细胞计数为（3.97 ± 7.39） × 10¹²/L，血红蛋白为（119.02 ± 21.49） g/L，均低于非感染者[（4.27 ± 0.44） × 10¹²/L，（126.52 ± 14.30）g/L ]（t = 2.556、 2.235，均P < 0.05）。人芽囊原虫基因测序结果共有4种基因型（ST1、ST3、ST6、ST7），以ST3为主，占57.1％（24/42）。

关键词: 人芽囊原虫, 粪样性状, 隐血, 混合感染

Abstract:

Basic information (gender, age, fecal characteristics, occult-blood test results, clinical signs and symptoms, etc) of long-term hospitalized patients in Tianmen First People’s Hospital during June—September 2021 collected. The fecal samples of patients were collected and examined under microscope by direct smear with normal saline. The DNA were extracted from the suspected Blastocystis hominis positive fecal samples. Specific primers of B. hominis BhRDr and RD5 were used to amplify the target bands, and the positive fecal samples were sent to Norsay Genomics Research Center for sequencing. Giardia lamblia and fragile bicarbonate amoeba infection were also observed in the fecal samples of the patients. Anticoagulant whole blood and non-anticoagulant venous blood were collected for blood analysis. Among the 857 patients, 42 cases were positive for B. hominis, with a positive rate of 4.90%. The positive rate of males was 4.27% (19/445) and that among the females was 5.58% (23/412). There was no significant difference between the gender groups (χ² = 0.791, P < 0.05). In different age groups, the positive rate was the highest in the ≥ 61 years old group (6.38%, 22/345). There was no significant difference in positive rates among different age groups (χ² = 2.700, P > 0.05). Among different fecal characters, the positive rate of the loose stool samples was the highest (18.37%, 27/147) (χ² = 98.930, P < 0.05). The positive rate was 6.72% (9/134) in patients with hematochezia and 4.56% (33/723) in patients without hematochezia, with no significant difference (χ² = 1.123, P > 0.05). Among different clinical symptoms, patients with abdominal pain and diarrhea had the highest positive rate (4/11) (χ² = 53.956, P < 0.05). Six patients were infected with B. hominis mixed with G. Lamblia, and two were infected with amoeba fragile. The red blood cell count and hemoglobin of B. hominis infected patients were (3.97 ± 7.39) × 10¹²/L and (119.02 ± 21.49) g/L, both of which were lower than that of the non-infected patients [(4.27 ± 0.44) × 10¹²/L, (126.52 ± 14.30) g/L] (t = 2.556, 2.235; P < 0.05). There were four genotypes of B. hominis (ST1, ST3, ST6 and ST7), and ST3 was the dominant one, accounting for 57.1% (24/42).

Key words: Blastocystis hominis, Fecal traits, Occult blood, Co-infection

中图分类号:

R382

朱名超, 朱娅, 赵建忠, 原慧真. 天门市长期住院患者人芽囊原虫感染情况分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(1): 121-124.

ZHU Mingchao, ZHU Ya, ZHAO Jianzhong, YUAN Huizhen. Analysis of Blastocystis hominis infection in long-term hospitalized patients in Tianmen City[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2023, 41(1): 121-124.

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参考文献 21

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实验室检查项目	参考范围	感染者数值	非感染者数值	t值	P值	95％CI 上限	95％CI 下限
白细胞计数	（3.5~9.5） × 10⁹/L	（6.40 ± 3.07） × 10⁹/L	（6.31 ± 2.09） × 10⁹/L	-0.251	0.802	-1.051	0.881
红细胞计数	（ 3.5~5.5） × 10¹²/L	（3.97 ± 7.39） × 10¹²/L	（4.27 ± 0.44） × 10¹²/L	2.556	0.014	0.062	0.526
血红蛋白	（120~160） g/L	（119.02 ± 21.49） g/L	（126.52 ± 14.30） g/L	2.235	0.031	0.731	14.257
血小板计数	（125~350） × 10⁹/L	（192.43 ± 86.65） × 10⁹/L	（216.20 ± 63.01） × 10⁹/L	1.754	0.086	-3.552	51.097
丙氨酸氨基转移酶	（11~16） IU/L	（23.32 ± 25.72） IU/L	（23.90 ± 13.01） IU/L	0.145	0.885	-7.583	8.757
天冬氨酸氨基转移酶	（35~56） IU/L	（28.01 ± 23.03） IU/L	（27.20 ± 15.98） IU/L	-0.195	0.846	-9.156	7.540
C反应蛋白	≤ 6 mg/L	（15.16 ± 30.13） mg/L	（6.41 ± 21.38） mg/L	-1.77	0.085	-18.760	1.253

天门市长期住院患者人芽囊原虫感染情况分析

Analysis of Blastocystis hominis infection in long-term hospitalized patients in Tianmen City

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	病例数	感染者人数	感染率/%	χ²值	P值
年龄组/岁
0~18	50	2	4.00	2.700	> 0.05
19~60	462	18	3.90
≥ 61	345	22	6.38
性别
男	445	19	4.27	0.791	> 0.05
女	412	23	5.58
粪样性状
成形便	356	2	0.56	98.930	< 0.01
半成形便	185	1	0.54
软便	151	9	5.96
稀便	147	27	18.37
水样便	18	3	3/18
隐血试验
未便血	723	33	4.56	1.123	> 0.05
便血	134	9	6.72
临床症状
食欲不振	4	1	1/4	53.956	< 0.01
腹泻	24	8	33.33
腹胀	7	2	2/7
腹痛或腹部不适	21	1	4.76
腹痛且腹泻	11	4	4/11
腹胀、腹痛且腹泻	3	0	0
无明显症状	787	26	3.30
检出其他寄生虫
检出蓝氏贾第鞭毛虫	8	6	6/8	57.484	< 0.01
检出脆弱双核阿米巴	3	2	2/3	0.155	> 0.05

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