【摘要】 目的观察甲硝唑治疗人芽囊原虫感染的疗效。方法115例患者因腹疼、腹泻及粘液血便行肠镜检查,肠镜下取病变粘膜做病理检查,并采集其新鲜粪便,行直接涂片法和三色染色法用光学显微镜检查,确诊人芽囊原虫阳性而其他寄生虫阴性者,予口服甲硝唑0.4 g/d,4次/d,连续服7 d。治疗3周后粪检仍阳性者,再重复用药7 d。30例患者治疗后复查电子肠镜,观察肠粘膜损伤的变化。结果甲硝唑治疗人芽囊原虫感染的总有效率为94.65%(230/243),其中服药7 d的治愈率76.54%(186/243);服药14 d的治愈率18.11%(44/243);治疗无效5.35%(13/243)。部分患者服药后出现恶心、呕吐、食欲不振等不良反应,占4.53%(11/243)。电子结肠镜检查,所检患者的肠道病变部位主要在左半结肠、直肠,表现为粘膜糜烂及溃疡;病理检查多为粘膜慢性炎症或溃疡病变。治疗后复查肠镜30例,肠粘膜损伤均获治愈。结论人芽囊原虫感染可引起肠粘膜糜烂及溃疡,口服甲硝唑治疗该病引起的肠粘膜损伤有较好的疗效,但少数患者出现药物不良反应或因产生抗药性而治疗无效。更多还原

【Abstract】 Objective To observe the effect of metronidazole in the treatment of Blastocystis hominis infection.Methods 115 patients who had abdominal pain,diarrhea and mucopurulent bloody stool,were performed colonoscopy,and were positive for B.hominis but negative for other parasites by feces examination.Their fresh fecal specimens were collected and examined by direct smear and trichrome stain method under light microscope,and intestinal biopsy,pathologic examination were also carried out.The patients were treated with metronidazole 0.4 g/d×7 d.After 3 weeks of therapy,if the feces examination was still positive for B.hominis,the metronidazole re-treatment would be used for another 7 d.The mucosa changes were re-examined by colonoscopy in 30 patients.Results The total clinical effective rate was 94.65%(230/243),thereinto,76.54%(186/243) by treatment 7 d and 18.11%(44/243) by treatment 14 d.The total side effects,such as nausea,vomitting,anorexia,accounted only for 4.53%(11/243).All the patients revealed intestinal mucosal erosion and ulcer by colonoscopy,the lesions located at the left of the colon and rectum.Most pathologic findings were mucosal chronic inflammation or ulceration.The mucosal lesions were healed up in 30 patients who were re-examined by colonoscopy.Conclusion B.hominis can cause intestinal mucosal lesions.Metronidazole may be a choice for the treatment of B.hominis infection,but there are trifling side effects and drug resistance in some patients.更多还原