呼吸道感染致病原—蠊缨滴虫的初步研究

陈元辉1 ，陈文俊2，王霞3 ，陈慧杰3

（1.青岛市黄岛区第一人民医院，山东 青岛，266555；2.青岛经济技术开发区第一人民医院，山东 青岛，266555； 3.青岛市黄岛区第二人民医院，山东 青岛，266555）

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摘要：

目的 探讨呼吸道疾病感染致病原—蠊缨滴虫的相关流行病学特征，为蠊缨滴虫的预防和治疗提供相应依据。方法 自2011年6月至2015年3月随机对361例呼吸道感染性疾病患者进行痰涂片及支气管灌洗液进行蠊缨滴虫检验，检出阳性 患者117 例。回顾性分析117 例蠊缨滴虫感染患者的临床资料，分析其一般临床表现、蠊缨滴虫滋养体及包囊形态特点、治 疗和转归情况。结果 蠊缨滴虫检出率为32.41%（117/361），不同性别蠊缨滴虫检出率比较，无显著差异（P>0.05），不同疾病患 者的蠊缨滴虫检出率有差异（P<0.05）。患者均有阵发性、刺激性咳嗽、咳痰、胸闷、气促；大多患者X 线表现为肺纹理增粗、紊乱；所有患者漱口液离心镜检未发现蠊缨滴虫，痰液细菌培养100例无致病菌生长，真菌培养阳性11 例，细菌培养阳性6 例。肝肾功能、尿常规均在正常范围。血常规检查有76 例嗜酸性粒细胞有不同程度的增高。因发育阶段及其观察时视角不 同其形态各异，有圆形、椭圆形、乌贼鱼形、虱形、石榴形等多种形态；包囊呈圆形或不规整椭圆形，大小12~35 μm，壁较厚，单层。50例随访患者经过半年随访后总的治愈率（无复发）为46.00%（23/50），复发率为34.30%（12/35）。结论 蠊缨滴虫在环 境不利于生长繁殖的情况下可形成包囊，致病性降低，而当环境条件适宜时则变为滋养体，致病性增强，这是蠊缨滴虫感染 者病情反复复发，病程迁延不愈的原因之一，目前对于蠊缨滴虫的临床治疗还需进一步研究。

关键词：蠊缨滴虫；感染；滋养体；包囊；传播途径

中图分类号：R532文献标志码：A文章编号：2096-1413(2017)32-0007-03

Preliminary study of respiratory tract infection pathogens-lophomonas blattarum
CHEN Yuan-hui 1, CHEN Wen-jun 2, WANG Xia 3, CHEN Hui-jie 3
(1. the First People``s Hospital of Huangdao District, Qingdao 266555; 2. the First People``s Hospital of Qingdao Economic and Technical Development Zone, Qingdao 266555; 3. the Second People``s Hospital of Huangdao District, Qingdao 266555, China)

ABSTRACT: Objective To investigate the epidemiological characteristics of respiratory tract infection pathogens -lophomonas blattarum, and to provide the basis for the prevention and treatment of lophomonas blattarum. Methods From June 2011 to March 2015, 361 patients with respiratory tract infection were randomly selected for sputum smear and bronchial lavage fluid testing for lophomonas blattarum, 117 cases were positive. The clinical data of the 117 cases were retrospectively analyzed, including the general clinical manifestations, morphological characteristics of trophozoite and cysts of lophomonas blattarum, treatment and prognosis. Results The detection rate of lophomonas blattarum was 32.41% (117/361), there was no significant difference in the detection rate of different sexes (P>0.05), the detection rate of different diseases was significant (P<0.05). Patients had paroxysmal, irritating cough, sputum, chest tightness, shortness of breath; the X-ray showed the lung markings were thickened and disordered; no lophomonas blattarum was found in the mouthwash of all patients, no pathogenic bacterium growed in 100 cases of putum bacterial culture, 11 cases of fungus culture were positive, 6 cases of bacterial culture were positive; the liver and kidney function, urine were in normal, blood routine examination showed 76 cases had eosinophils increas in varying degrees. There were round, oval, squid fish, lice, pomegranate and other forms of lophomonas blattarum because of different developmental stage and observation angle; cysts were round or irregular oval, 12-35 μm, thick wall, single layer. The overall cure rate (no recurrence) was 46.00% (23/50) and the recurrence rate was 34.30% (12/35) after half a year follow-up. Conclusion Lophomonas blattarum can form cysts when the environment is not conducive to the growth and reproduction, and its pathogenicity decrease, and when the environmental conditions are appropriate, trophozoites formed and its pathogenicity increase, that is one of the causes of the recurrence of the disease, at present, the clinical treatment of lophomonas blattarum need further study.
KEYWORDS: lophomonas blattarum; infection; trophozoites; cyst; route of transmission

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