肝肺吸虫课件

NemotodaCestodaTrematodaMedicalhelminth.NemotodaMedicalhelminth.1LiverFluke.VocabularyDioecism[dai‘i:sizəm]雌雄异体Hermaphroditic[hə:mæfrɔ‘ditik]雌雄同体Miracidium[‘mairə‘sidiəm]毛蚴Sporocyst[‘spɔ:rə‘sist]胞蚴Encytedmetacercaria[‘metəsə:’kɛəriə]囊蚴Rediae雷蚴Cercariae尾蚴Encyst-excyst成囊-脱囊.LiverFluke.VocabularyDioecism2LiverFluke.VocabularyBile胆汁Clonorchiasis[’kləunɔ:’kaiəsis]

肝吸虫病Intrahepaticbileduct肝胆管Pancreatic胰腺的Gallbladder胆囊Faeces[’fi:si:z]粪便Diarrhoea[’daɪə’rɪə]腹泻putrescent[pju:’tresnt]

坏死.LiverFluke.VocabularyBile胆汁3LiverFluke.VocabularyHepatocirrhosis

[’hepətəusi’rəusis]肝硬化Atrophy[’ætrəfi]萎缩ascites[ə’saiti:z]腹水.LiverFluke.VocabularyHepatoci4

Trematodes,FlukesGeneralcharacters.Trematodes,FlukesGeneralcha5

MophologyGeneralcharacters

Leave-shaped,flatHermaphroditic(exceptSchistosome)havemouthbutnoanusWithoralsuckerandventralsuckerMostfluke’segghasaoperculum.MophologyGeneralcharacters6Adultworms

eggscercariaRediaeSporocystMiracidia

encystedmetacercariaLifecycleDefinitivehostSecondintermediatehostFirstintermediatehostGeneralcharacters

Mophology.AdultwormscercariaRediaeSpor7metagenesisasexualgenerationSexualgenerationGeneralcharacters

MophologyLifecycle.metagenesisasexualgenerationS8Morethan30speciesofflukesparasiticinhumanbody,allbelongtoPhylumPlatyminthes(扁形动物门）

ClassTrematoda（吸虫纲）

OrderDigenea（复殖目）Generalcharacters

speciesofflukes.Morethan30speciesoffluke9Flukesendemicinchina

Clonorchissinensis华支睾吸虫

Paragonimuswestermani

卫氏并殖吸虫

Schistosomajaponicum

日本血吸虫

Fasciolopsisbuski

布氏姜片吸虫

Pagumogonimusskrjabini

斯氏狸殖吸虫Generalcharacters

speciesofflukes.FlukesendemicinchinaClono10华支睾吸虫(Clonorchissinensis)introduction肝吸虫(liverfluke）causingClonorchiasisFirstlyfoundinaIndianChinese’sbileductin1874..华支睾吸虫(Clonorchissinensis)intr11

MorphologyLifecyclePathogenesisDiagnosisPrevalenceProphylaxis肝吸虫(liverfluke）华支睾吸虫(Clonorchissinensis).Morphology肝吸虫(liverfluke）华支睾12LiverflukeMorphology10-25×3-5mmOralsuckerVentralsuckerSpermary睾丸Uterus子宫Intestinebranch1.AdultwormGullet咽Overy卵巢.LiverflukeMorphology10-25×3-131.AdultwormLiverflukemorphology.1.AdultwormLiverflukemorpho14Sesamelike,broadlyovoidLightyellowish-brown2.egg29×17um，sizecolorshapeshellContainingWithadistinctconvexoperculumamiracidiuminsidetheeggLiverflukemorphology.Sesamelike,broadlyovoidLigh152.egg卵盖operculum肩峰shoulder卵壳shell毛蚴miracidium疣状突起tinyknobLiverflukemorphologysizecolorshapeshellContaining.2.egg卵盖operculum肩峰shoulder卵壳s16蠕虫卵中我最小，形似芝麻棕黄色。上有盖来下有疣，肩峰明显内毛蚴。2.eggLiverflukemorphology.蠕虫卵中我最小，2.eggLiverflukemorph17MiracidiumLiverflukemorphology3.Otherstage.MiracidiumLiverflukemorpholo18Liverflukemorphologyotherstages

sporocyst3.Otherstage.Liverflukemorphologyothers19rediaeLiverflukemorphologyotherstages

GenerationcellUnmatureCercariae3.Otherstage.rediaeLiverflukemorphologyo20CercariaeLiverflukemorphologyotherstages

3.Otherstage.CercariaeLiverflukemorpholog21Liverflukemorphologyotherstages

FreshwaterfishEncystedmetacercariaeinfishmusculature3.Otherstage.Liverflukemorphologyothers22Liverflukelifecycle

FirstintermidiatehostSecondintermidiatehostDefinitivehostshrimpCyprinidaesnail.LiverflukelifecycleFirst23Liverflukelifecycle

Adult

wormseggmiracidiumSporacyst

rediaecercariaeEncyctedmtacercariae.LiverflukelifecycleAdult24尾蚴雷蚴胞蚴毛蚴囊蚴猫25-30d鼠21d100d25℃时，30-40d童虫成虫卵Liverflukelifecycle

.尾蚴雷蚴胞蚴毛蚴囊蚴猫25-30d100d25℃时，30-251.host纹沼螺长角涵螺赤豆螺(1)thefirstintermediatehost—freshwatersnailLiverflukelifecycle

.1.host纹沼螺(1)thefirstint261.host(1)thefirstintermediatehost—freshwatersnail(2)thesecondintermediatehost—

freshwaterfish(familyCyprinidae鲤科)Liverflukelifecycleconclusion

.1.host(1)thefirstintermedia27(3)Definitivehost—human，cat,dog,pig,rat,etal.

1.Host(1)thefirstintermediatehost—

freshwatersnail(2)thesecondintermediatehost—

freshwaterfish(familyCyprinidae)Liverflukelifecycleconclusion

.(3)Definitivehost1.Host(1281.Host2.Infectionstageandmethodinfectionstage----encystedmetacercariaeinfectionway----ingestionofraw,undercooked,pickledfishharbouringmetacercariaeLiverflukelifecycleconclusion

.1.Hostinfectionstage----ency291.Host2.Infectionstageandmethod3.ExcretewayinhumanbodyInmaturewormcommonbileductbloodstreamabdomenantrum

BilepassagesLiverflukelifecycleconclusion

through.1.HostInmaturecommonbiledu301.Host2.Infectionstageandmethod3.Excretewayinhumanbody4.Parasiting

position

AdultwormsareparasiticinbileductsLiverflukelifecycleconclusion

.1.HostAdultwormsareLiverf311.host2.infectionstageandmethod3.passingwayinhumanbody4.parasitizedposition5.leavingbodystageandmethod

eggsexitthebileductandareexcretedinthefaecesLiverflukelifecycleconclusion

.1.hosteggsexitthebiledu32PathogeneticstagePathogeneticmechenismSymptomologyLiverflukepathogenicity

.PathogeneticstageLiverfluke33ImmatureadultwormMatureadultwormEggsLiverflukepathogenicity

pathogeneticstagePathogeneticmechanismSymptomology.ImmatureadultwormLiverfluke34metablitesandmechanicaleffectscausesproliferativeandinflammatoryreactionsinthebiliaryepitheliumofthebileducts.Encapsulating

fibrosisoftheductsBile

ductsaredilatedatthepointswheretheflukesareattachedtotheinnerliningpathogeneticstagePathogeneticmechanismSymptomologyLiverflukepathogenicity

.metablitesandmechanicaleff35②chronicinfection,hepaticcellsnearthebilepassagesbecomedenaturalizedand

putrescent(坏死)，causinghepatictissueatrophy(萎缩)apparently.③lateperiod,causinghepatocirrhosis(肝硬化)andascites(腹水).①ifparasitizedbylargeamountofflukes,bileductwillbeobstructed,bileisblockedandicteruswillhappen.Liverflukepathogenicity

pathogeneticstagePathogeneticmechanismSymptomology.②chronicinfection,hepaticce36OtherdiseasescausedCholecystitis(胆囊炎)，cholangitis(胆管炎)，hepatitis(肝炎)；cholelithiasis(胆石症)pancreaticinflammatory(胰腺炎)cholangiocarcinoma(胆管上皮癌)hepatiticcancer肝癌；hypogenesis(发育不良)Liverflukepathogenicity

pathogeneticstagePathogeneticmechanismSymptomology.OtherdiseasescausedLiverfl37头痛乏力，消化不良；腹痛腹泻，上腹不适；肝区隐痛，常不明显。头乏消肝痛，三腹并不适Liverflukepathogenicity

pathogeneticstagePathogeneticmechanismSymptomologyHeadache,beingtiredanddyspepsia,abdominaldistress,diarrhoea,midsectionbeingdiscomfortable,andwithminorsymptomofacheinliver..头痛乏力，消化不良；头乏消肝痛，三腹并不适Liverfl38withasymptomoftumefactionintheliverandspleenLiverflukepathogenicity

pathogeneticstagePathogeneticmechanismSymptomology.withasymptomoftumefaction391.diagnosisofpathogenyoffecesby（steakfecesonaslide,concentrationofeggs）ofaspiratedbilebyduodenalaspiration

胆汁（十二指肠引流）LiverflukediagnosisdemonstrationofEggsbymicroscopicalexamination.1.diagnosisofpathogenyof402.immunodiagnosis（forscreeningpatientsprimarily,andassistanceofdiagnosis）skintestusingextractsofadultliverfluke皮试indirecthaemagglutinationassay(IHA)ELISALiverflukediagnosisDemonstrationofantibodiesagainstliverfluke.2.immunodiagnosis（forscreenin411.distributionallovertheworld,especiallyinChina,Japan,Korea,Vietnam,andSouthestAsia我国：内.宁.西.海.新尚无内蒙、宁夏、西藏青海、新疆高发区：珠江三角洲Liverflukeprevalence.1.distributionalloverthewo421.ditribution2.elementsrelevanttoprevalenceIntermidiatedhostThechanceofswallowingtheencystedmetacercariaeThesouceofinfectionEggsenterwaterLiverflukeprevalence.1.ditribution2.elementsreleva431997年广东省不同鱼种肝吸虫的感染率（%）麦穗鱼61.22白鲢56.3白鲩55.6花鲢54.6Liverflukeprevalence.1997年广东省不同鱼种肝吸虫的感染率（%）Liverfl44IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeThesouceofinfectionEggsenterwaterLiverflukeprophylaxis.IntermidiatedThechanceofsw45IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeThesouceofinfectionEggsenterwaterLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson.IntermidiatedThechanceofsw46IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeEggsenterwaterLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson.IntermidiatedThechanceofsw47IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeEggsenterwaterLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson2.Dealwithfeces..IntermidiatedThechanceofsw48IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson2.Dealwithfeces..IntermidiatedThechanceofsw49IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson2.Dealwithfeces.3.Changethehabitofeating(uncookedfish)；.IntermidiatedThechanceofsw50IntermidiatedhostLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson2.Dealwithfeces.3.Changethehabitofeating(uncookedfish)；.IntermidiatedLiverflukepr51并殖吸虫（Paragonimus)第三节.肺吸虫（lungflukes)概述卫氏并殖吸虫（肺型）斯氏狸殖吸虫（皮肤型）.并殖吸虫（Paragonimus)第三节.肺吸虫（lung52并殖吸虫（Paragonimus)（一）肺吸虫（lungflukes)卫氏并殖吸虫.并殖吸虫（Paragonimus)（一）肺吸虫（lungf53肺吸虫形态

1.成虫

长7-12mm宽4-6mm厚3.5-5.肺吸虫形态1.成虫长7-12mm.54肺吸虫形态

1.成虫体棘游走习性.肺吸虫形态1.成虫体棘游走习性.55肺吸虫形态

2.虫卵大小颜色形状结构56100um.肺吸虫形态2.虫卵大小颜色形状结构56100um56肺吸虫形态

2.虫卵卵壳卵黄细胞卵细胞卵盖56100um大小颜色形状结构.肺吸虫形态2.虫卵卵壳卵黄细胞卵细胞卵盖56100um57肺吸虫形态

3.其他雷蚴囊蚴尾蚴.肺吸虫形态3.其他雷蚴囊蚴尾蚴.58肺吸虫生活史

.肺吸虫生活史.59尾蚴母雷蚴子雷蚴胞蚴毛蚴童虫成虫卵囊蚴肺吸虫生活史

.尾蚴母雷蚴胞蚴毛蚴童虫囊蚴肺吸虫生活史.601.宿主2.感染阶段及方式3.移行途径4.寄生部位5.离体阶段及方式①第一中间宿主—川卷螺肺吸虫生活史

.1.宿主①第一中间宿主—川卷螺肺吸虫生活史.611.宿主2.感染阶段及方式3.移行途径4.寄生部位5.离体阶段及方式①第一中间宿主—川卷螺②第二中间宿主—溪蟹、蝲蛄肺吸虫生活史

.1.宿主①第一中间宿主—川卷螺②第二中间宿主—溪蟹621.宿主2.感染阶段及方式3.移行途径4.寄生部位5.离体阶段及方式③终宿主—人，肉食性的哺乳动物

（保虫宿主）①第一中间宿主—川卷螺②第二中间宿主—溪蟹、蝲蛄肺吸虫生活史

.1.宿主③终宿主—人，肉食性的哺乳动物①第一中间宿主631.宿主2.感染阶段及方式3.移行途径4.寄生部位5.离体阶段及方式感染阶段：囊蚴感染方式：生食/半生食溪蟹、蝲蛄

肺吸虫生活史

.1.宿主感染阶段：囊蚴肺吸虫生活史.641.宿主2.感染阶段及方式3.移行途径4.寄生部位5.离体阶段及方式肺吸虫生活史

皮下肠壁腹腔膈肌胸腔肺童虫腹壁纵隔心、脑.1.宿主肺吸虫生活史皮下肠壁腹腔膈肌胸腔肺童虫腹壁纵隔心651.宿主2.感染阶段及方式3.移行途径4.寄生部位5.离体阶段及方式肺吸虫生活史

虫囊.1.宿主肺吸虫生活史虫囊.661.宿主2.感染阶段及方式3.移行途径4.寄生部位5.离体阶段及方式肺吸虫生活史

虫卵去向：虫囊完整时，虫卵沉积于囊内；虫囊与血管相通：引起小血管栓塞；虫囊与淋巴管相通：虫卵沉积于肺淋巴结；

虫囊与支气管相通：虫卵随痰/粪排出体外。.1.宿主肺吸虫生活史虫卵去向67肺吸虫致病

致病阶段致病机理临床表现.肺吸虫致病致病阶段.68肺吸虫致病

致病阶段致病机理临床表现童虫、成虫.肺吸虫致病致病阶段童虫、成虫.69肺吸虫致病

致病阶段致病机理临床表现童虫/成虫的机械性损伤及异物反应。脓肿期囊肿期纤维斑痕期肺型肺吸虫病：.肺吸虫致病致病阶段童虫/成虫的机械性损伤及异物反应。脓70肺吸虫致病

致病阶段致病机理临床表现童虫/成虫的机械性损伤及异物反应。脓肿期囊肿期纤维斑痕期细胞浸润局部出血组织坏死肉芽组织增生并包围虫体，囊内可见大量虫卵和夏科雷登结晶虫体转移或死亡，形成疤痕病理变化X线特征浸润性阴影多房性囊样阴影硬结性或条索性阴影肺型肺吸虫病：.肺吸虫致病致病阶段童虫/成虫的机械性损伤及异物反应。脓71肺吸虫致病

致病阶段致病机理临床表现童虫/成虫的机械性损伤及异物反应。肺型肺吸虫病：腹腔型：引起广泛的炎症反应和粘连胸腔型：胸膜炎，纵隔炎脑型：占位性病变及损伤皮肤型：游走性的皮下包块或结节.肺吸虫致病致病阶段童虫/成虫的机械性损伤及异物反应。72肺吸虫致病

致病阶段致病机理临床表现轻症：表现为食欲不振、乏力、消瘦、低热等非特异性症状；重症：毒性症状明显，如高热、腹痛、腹泻等。血象：白细胞↑，嗜酸性粒细胞↑↑（20--40%）.肺吸虫致病致病阶段轻症：表现为食欲不振、乏力、消重症731.病原检查：①查虫卵：痰、粪便②组织活检：皮下包块2.免疫学诊断：

①皮试：阳性率可达98-100%②IHA：阳性滴度在1：20以上；③ELISA：阳性率可达90-100%。肺吸虫实验诊断

.1.病原检查：2.免疫学诊断：肺吸虫实验诊断.74..75五、传播与流行流行因素：1、病人和保虫宿主的存在：犬、猫、猪2、中间宿主的存在：第一中间宿营主——川卷螺有十多种第二中间宿主——淡水蟹能传播卫氏并殖吸虫者有20余种。3、生吃或半生吃溪蟹、喇蛄或动物肉类（转续宿主）的不良习惯。.五、传播与流行流行因素：.76六、防治原则（一）防止病从口入，不吃生食，不喝生水，防止囊蚴污染餐具。（二）加强粪便管理，不随地吐痰。（三）治疗病人，病畜，常用药物有吡喹酮、硫双二氯酚）又名别丁）等。.六、防治原则（一）防止病从口入，不吃生食，不喝生水，防止囊蚴77小结1、肝吸虫卵是肠道寄生虫卵中最小的虫卵之一，镜下呈芝麻状；颜色是棕黄色；卵壳具卵盖；盖上有肩峰；底部有一疣状突起；内容物是一条毛蚴。2、肝吸虫生活史过程中第一中间宿主是淡水螺，第二中间宿主是淡水鱼虾。3、肝吸虫寄生于肝胆管，虫体的机械刺激及分泌物的化学刺激，使肝胆管上皮细胞脱落增生，管壁因结缔组织增生而增厚。.小结1、肝吸虫卵是肠道寄生虫卵中最小的虫卵之一，镜下呈芝麻状78小结4、病原学诊断：查虫卵，十二指肠引流胆汁进行离心沉淀查虫卵。5、肺吸虫卵较大；椭圆形；金黄色；卵壳表面光滑，厚薄不均，大多有卵盖；内容物是一个卵细胞及十多个卵黄细胞6、肺吸虫成虫寄生于肺，但有腹腔型、胸腔型、脑型、皮肤型的异位寄生。.小结4、病原学诊断：查虫卵，十二指肠引流胆汁进行离心沉淀查虫79问答题：1、肝吸虫病、肺吸虫病的防治应注意哪些环节？2、肝肺吸虫病的临床表现有哪些？.问答题：1、肝吸虫病、肺吸虫病的防治应注意哪些环节？.80..81NemotodaCestodaTrematodaMedicalhelminth.NemotodaMedicalhelminth.82LiverFluke.VocabularyDioecism[dai‘i:sizəm]雌雄异体Hermaphroditic[hə:mæfrɔ‘ditik]雌雄同体Miracidium[‘mairə‘sidiəm]毛蚴Sporocyst[‘spɔ:rə‘sist]胞蚴Encytedmetacercaria[‘metəsə:’kɛəriə]囊蚴Rediae雷蚴Cercariae尾蚴Encyst-excyst成囊-脱囊.LiverFluke.VocabularyDioecism83LiverFluke.VocabularyBile胆汁Clonorchiasis[’kləunɔ:’kaiəsis]

肝吸虫病Intrahepaticbileduct肝胆管Pancreatic胰腺的Gallbladder胆囊Faeces[’fi:si:z]粪便Diarrhoea[’daɪə’rɪə]腹泻putrescent[pju:’tresnt]

坏死.LiverFluke.VocabularyBile胆汁84LiverFluke.VocabularyHepatocirrhosis

[’hepətəusi’rəusis]肝硬化Atrophy[’ætrəfi]萎缩ascites[ə’saiti:z]腹水.LiverFluke.VocabularyHepatoci85

Trematodes,FlukesGeneralcharacters.Trematodes,FlukesGeneralcha86

MophologyGeneralcharacters

Leave-shaped,flatHermaphroditic(exceptSchistosome)havemouthbutnoanusWithoralsuckerandventralsuckerMostfluke’segghasaoperculum.MophologyGeneralcharacters87Adultworms

eggscercariaRediaeSporocystMiracidia

encystedmetacercariaLifecycleDefinitivehostSecondintermediatehostFirstintermediatehostGeneralcharacters

Mophology.AdultwormscercariaRediaeSpor88metagenesisasexualgenerationSexualgenerationGeneralcharacters

MophologyLifecycle.metagenesisasexualgenerationS89Morethan30speciesofflukesparasiticinhumanbody,allbelongtoPhylumPlatyminthes(扁形动物门）

ClassTrematoda（吸虫纲）

OrderDigenea（复殖目）Generalcharacters

speciesofflukes.Morethan30speciesoffluke90Flukesendemicinchina

Clonorchissinensis华支睾吸虫

Paragonimuswestermani

卫氏并殖吸虫

Schistosomajaponicum

日本血吸虫

Fasciolopsisbuski

布氏姜片吸虫

Pagumogonimusskrjabini

斯氏狸殖吸虫Generalcharacters

speciesofflukes.FlukesendemicinchinaClono91华支睾吸虫(Clonorchissinensis)introduction肝吸虫(liverfluke）causingClonorchiasisFirstlyfoundinaIndianChinese’sbileductin1874..华支睾吸虫(Clonorchissinensis)intr92

MorphologyLifecyclePathogenesisDiagnosisPrevalenceProphylaxis肝吸虫(liverfluke）华支睾吸虫(Clonorchissinensis).Morphology肝吸虫(liverfluke）华支睾93LiverflukeMorphology10-25×3-5mmOralsuckerVentralsuckerSpermary睾丸Uterus子宫Intestinebranch1.AdultwormGullet咽Overy卵巢.LiverflukeMorphology10-25×3-941.AdultwormLiverflukemorphology.1.AdultwormLiverflukemorpho95Sesamelike,broadlyovoidLightyellowish-brown2.egg29×17um，sizecolorshapeshellContainingWithadistinctconvexoperculumamiracidiuminsidetheeggLiverflukemorphology.Sesamelike,broadlyovoidLigh962.egg卵盖operculum肩峰shoulder卵壳shell毛蚴miracidium疣状突起tinyknobLiverflukemorphologysizecolorshapeshellContaining.2.egg卵盖operculum肩峰shoulder卵壳s97蠕虫卵中我最小，形似芝麻棕黄色。上有盖来下有疣，肩峰明显内毛蚴。2.eggLiverflukemorphology.蠕虫卵中我最小，2.eggLiverflukemorph98MiracidiumLiverflukemorphology3.Otherstage.MiracidiumLiverflukemorpholo99Liverflukemorphologyotherstages

sporocyst3.Otherstage.Liverflukemorphologyothers100rediaeLiverflukemorphologyotherstages

GenerationcellUnmatureCercariae3.Otherstage.rediaeLiverflukemorphologyo101CercariaeLiverflukemorphologyotherstages

3.Otherstage.CercariaeLiverflukemorpholog102Liverflukemorphologyotherstages

FreshwaterfishEncystedmetacercariaeinfishmusculature3.Otherstage.Liverflukemorphologyothers103Liverflukelifecycle

FirstintermidiatehostSecondintermidiatehostDefinitivehostshrimpCyprinidaesnail.LiverflukelifecycleFirst104Liverflukelifecycle

Adult

wormseggmiracidiumSporacyst

rediaecercariaeEncyctedmtacercariae.LiverflukelifecycleAdult105尾蚴雷蚴胞蚴毛蚴囊蚴猫25-30d鼠21d100d25℃时，30-40d童虫成虫卵Liverflukelifecycle

.尾蚴雷蚴胞蚴毛蚴囊蚴猫25-30d100d25℃时，30-1061.host纹沼螺长角涵螺赤豆螺(1)thefirstintermediatehost—freshwatersnailLiverflukelifecycle

.1.host纹沼螺(1)thefirstint1071.host(1)thefirstintermediatehost—freshwatersnail(2)thesecondintermediatehost—

freshwaterfish(familyCyprinidae鲤科)Liverflukelifecycleconclusion

.1.host(1)thefirstintermedia108(3)Definitivehost—human，cat,dog,pig,rat,etal.

1.Host(1)thefirstintermediatehost—

freshwatersnail(2)thesecondintermediatehost—

freshwaterfish(familyCyprinidae)Liverflukelifecycleconclusion

.(3)Definitivehost1.Host(11091.Host2.Infectionstageandmethodinfectionstage----encystedmetacercariaeinfectionway----ingestionofraw,undercooked,pickledfishharbouringmetacercariaeLiverflukelifecycleconclusion

.1.Hostinfectionstage----ency1101.Host2.Infectionstageandmethod3.ExcretewayinhumanbodyInmaturewormcommonbileductbloodstreamabdomenantrum

BilepassagesLiverflukelifecycleconclusion

through.1.HostInmaturecommonbiledu1111.Host2.Infectionstageandmethod3.Excretewayinhumanbody4.Parasiting

position

AdultwormsareparasiticinbileductsLiverflukelifecycleconclusion

.1.HostAdultwormsareLiverf1121.host2.infectionstageandmethod3.passingwayinhumanbody4.parasitizedposition5.leavingbodystageandmethod

eggsexitthebileductandareexcretedinthefaecesLiverflukelifecycleconclusion

.1.hosteggsexitthebiledu113PathogeneticstagePathogeneticmechenismSymptomologyLiverflukepathogenicity

.PathogeneticstageLiverfluke114ImmatureadultwormMatureadultwormEggsLiverflukepathogenicity

pathogeneticstagePathogeneticmechanismSymptomology.ImmatureadultwormLiverfluke115metablitesandmechanicaleffectscausesproliferativeandinflammatoryreactionsinthebiliaryepitheliumofthebileducts.Encapsulating

fibrosisoftheductsBile

ductsaredilatedatthepointswheretheflukesareattachedtotheinnerliningpathogeneticstagePathogeneticmechanismSymptomologyLiverflukepathogenicity

.metablitesandmechanicaleff116②chronicinfection,hepaticcellsnearthebilepassagesbecomedenaturalizedand

putrescent(坏死)，causinghepatictissueatrophy(萎缩)apparently.③lateperiod,causinghepatocirrhosis(肝硬化)andascites(腹水).①ifparasitizedbylargeamountofflukes,bileductwillbeobstructed,bileisblockedandicteruswillhappen.Liverflukepathogenicity

pathogeneticstagePathogeneticmechanismSymptomology.②chronicinfection,hepaticce117OtherdiseasescausedCholecystitis(胆囊炎)，cholangitis(胆管炎)，hepatitis(肝炎)；cholelithiasis(胆石症)pancreaticinflammatory(胰腺炎)cholangiocarcinoma(胆管上皮癌)hepatiticcancer肝癌；hypogenesis(发育不良)Liverflukepathogenicity

pathogeneticstagePathogeneticmechanismSymptomology.OtherdiseasescausedLiverfl118头痛乏力，消化不良；腹痛腹泻，上腹不适；肝区隐痛，常不明显。头乏消肝痛，三腹并不适Liverflukepathogenicity

pathogeneticstagePathogeneticmechanismSymptomologyHeadache,beingtiredanddyspepsia,abdominaldistress,diarrhoea,midsectionbeingdiscomfortable,andwithminorsymptomofacheinliver..头痛乏力，消化不良；头乏消肝痛，三腹并不适Liverfl119withasymptomoftumefactionintheliverandspleenLiverflukepathogenicity

pathogeneticstagePathogeneticmechanismSymptomology.withasymptomoftumefaction1201.diagnosisofpathogenyoffecesby（steakfecesonaslide,concentrationofeggs）ofaspiratedbilebyduodenalaspiration

胆汁（十二指肠引流）LiverflukediagnosisdemonstrationofEggsbymicroscopicalexamination.1.diagnosisofpathogenyof1212.immunodiagnosis（forscreeningpatientsprimarily,andassistanceofdiagnosis）skintestusingextractsofadultliverfluke皮试indirecthaemagglutinationassay(IHA)ELISALiverflukediagnosisDemonstrationofantibodiesagainstliverfluke.2.immunodiagnosis（forscreenin1221.distributionallovertheworld,especiallyinChina,Japan,Korea,Vietnam,andSouthestAsia我国：内.宁.西.海.新尚无内蒙、宁夏、西藏青海、新疆高发区：珠江三角洲Liverflukeprevalence.1.distributionalloverthewo1231.ditribution2.elementsrelevanttoprevalenceIntermidiatedhostThechanceofswallowingtheencystedmetacercariaeThesouceofinfectionEggsenterwaterLiverflukeprevalence.1.ditribution2.elementsreleva1241997年广东省不同鱼种肝吸虫的感染率（%）麦穗鱼61.22白鲢56.3白鲩55.6花鲢54.6Liverflukeprevalence.1997年广东省不同鱼种肝吸虫的感染率（%）Liverfl125IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeThesouceofinfectionEggsenterwaterLiverflukeprophylaxis.IntermidiatedThechanceofsw126IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeThesouceofinfectionEggsenterwaterLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson.IntermidiatedThechanceofsw127IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeEggsenterwaterLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson.IntermidiatedThechanceofsw128IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeEggsenterwaterLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson2.Dealwithfeces..IntermidiatedThechanceofsw129IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson2.Dealwithfeces..IntermidiatedThechanceofsw130IntermidiatedhostThechanceofswallowingtheencystedmetacercariaeLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson2.Dealwithfeces.3.Changethehabitofeating(uncookedfish)；.IntermidiatedThechanceofsw131IntermidiatedhostLiverflukeprophylaxis1.Curethepatientsandasymptomaticinfectedperson2.Dealwithfeces.3.Changethehabitofeating(uncookedfish)；.IntermidiatedLiverflukepr132并殖吸虫（Paragonimus)第三节.肺吸虫（lungflukes)概述卫氏并殖吸虫（肺型）斯氏狸殖吸虫（皮肤型）.并殖吸虫（Paragonimus)第三节.肺吸虫（lung133并殖吸虫（Paragonimus)（一）肺吸虫（lungflukes)卫氏并殖吸虫.并殖吸虫（Paragonimus)（一）肺吸虫（lungf134肺吸虫形态

1.成虫

长7-12mm宽4-6mm厚3.5-5.肺吸虫形态1.成虫长7-12mm.135肺吸虫形态

1.成虫体棘游走习性.肺吸虫形态1.成虫体棘游走习性.136肺吸虫形态

2.虫卵大小颜色形状结构56100um.肺吸虫形态2.虫卵大小颜色形状结构56100um137肺吸虫形态

2.虫卵卵壳卵黄细胞卵细胞卵盖56100um大小颜色形状结构.肺吸虫形态2.虫卵卵壳卵黄细胞卵细胞卵盖56100um138肺吸虫形态

3.其他雷蚴囊蚴尾蚴.肺吸虫形态3.其他雷蚴囊蚴尾蚴.139肺吸虫生活史

.肺吸虫生活史.140尾蚴母雷蚴子雷蚴胞蚴毛蚴童虫成虫卵囊蚴肺吸虫生活史

.尾蚴母雷蚴胞蚴毛蚴童虫囊蚴肺吸虫生活史.1411.宿主2.感染阶段及方式3.移行途径4.寄生部位5.离体阶段