中国寄生虫学与寄生虫病杂志 ›› 2010, Vol. 28 ›› Issue (6): 5-423-426.

• 论著 • 上一篇    下一篇

土源性线虫感染儿童智力水平和认知结构特征的研究

尚煜1,2,汤林华1 *   

  1. 1 中国疾病预防控制中心寄生虫病预防控制所,世界卫生组织疟疾、血吸虫病和丝虫病合作中心,上海 200025;
    2 河北省妇幼保健中心,石家庄 050031
  • 出版日期:2010-12-31 发布日期:2011-03-07

Intelligence Level and Characteristics of Cognitive Structure in School-age Children Infected with Soil-transmitted Helminthes

SHANG Yu1,2,TANG Lin-hua1 *   

  1. 1 National Institute of Parasitic Diseases,Chinese Center for Disease Control and Prevention;WHO Collaborating Centre for Malaria,Schistosomiasis and Filariasis,Shanghai 200025, China;2 Woman and Child Health Care Center of Hebei Province,Shijiazhuang 050031,China
  • Online:2010-12-31 Published:2011-03-07

摘要:   【摘要】  目的  从认知结构不同维度对土源性线虫(钩虫、蛔虫和鞭虫)感染儿童的认知能力进行评估和鉴定,探讨土源性线虫感染儿童的认知结构特征。 方法  选取土源性线虫感染率较高的广西融水县白云乡、海南定安县龙州镇和新竹镇等3个乡镇的农村小学1 031名9~12岁儿童进行调查,采用改良加藤厚涂片法(Kato?鄄Katz)检查钩虫、蛔虫和鞭虫的虫卵(一粪三检)。选取77例仅感染1种线虫者作为病例组,并以年龄、性别等与病例组相匹配的健康儿童39人为对照,共计116例,采用韦克斯勒儿童智力量表第4版(WISC-Ⅳ)进行认知能力诊断与测量评估。 结果  检出土源性线虫感染378例,感染率为36.7%(378/1 031); 中、重度感染173例, 感染率为16.8%(173/1 031)。土源性线虫感染儿童除知觉推理指数外,其总智商分数、言语理解指数、工作记忆指数和加工速度指数得分显著低于健康对照组(P<0.05)。中重度土源性线虫感染儿童在总智商分数(95.4)、言语理解指数(97.2)、工作记忆指数(84.6)和加工速度指数(91.1)均显著低于轻度感染组(分别为99.2、103.3、88.3和99.1)和健康对照组(分别为102.0、104.2、91.9和100.1)(P<0.05)。单纯钩虫感染组的工作记忆指数(83.7)显著低于蛔虫组(87.6)和鞭虫组(88.3)(P<0.05),单纯鞭虫感染组的加工速度指数(92.8)显著低于蛔虫组(97.3)和钩虫组(94.4)(P<0.05)。 结论  土源性线虫感染儿童的智力水平在正常范围,但处于较低或边缘状态,言语理解、工作记忆和加工速度等方面的认知功能存在不足,尤其是中重度土源性线虫感染影响儿童智力水平和认知功能。

关键词: 土源性线虫, 学龄儿童, 病例对照研究, 认知功能

Abstract: 【Abstract】   Objective   To investigate the intelligence level and characteristics of cognitive structure of school-age children infected with soil-transmitted helminthes (STH)(hookworm, Ascaris lumbricoides and Trichuris trichiura).   Methods  1 031 children of 9 to 12 years old from Baishui village of Guangxi, Longzhou and Xinzhu villages of Hainan were selected for the survey. Stool samples from children were collected and examined by modified Kato-Katz method. 77 children infected with only one species (hookworm,  A. lumbricoides, or T. trichiura) were used as case group and 39 healthy children as control. The cognitive ability for children were assessed by WISC-Ⅳ.   Results   A total of 378 cases with STH infection was found from 1 031 children, and the overall prevalence of STH infection was 36.7%. The prevalence of moderate and heavy STH infections was 16.8% (173/1 031). The verbal comprehension (VCI), working memory (WMI), processing speed (PSI) and full scale IQ (FSIQ) indices of case group were lower than those of control group (P<0.05). The VCI (97.2), WMI (84.6), PSI (91.1) and FSIQ (95.4) indices in moderate/heavy infection group were lower than those in light infection group (99.2,103.3,88.3 and 99.1, respectively) and control group (102.0,104.2,91.9 and 100.1,  respectively)(P<0.05). The WMI index in hookworm infection group (83.7) was lower than that in A. lum-bricoides (87.6) or T. trichiura (88.3) infection groups (P<0.05). The PSI index of T. trichiura infection group (92.8) was lower than that of A. lumbricoides (97.3) or hookworm (94.4) infection groups (P<0.05).   Conclusion   The total intelligence level of STH infection children is in a normal range, or on borderline. The low VCI, WMI, PSI indices have been found in moderate/heavy STH infection children.

Key words:  , Soil-transmitted helminth;School-age children;Case control;Cognitive function