人體腸道人芽囊原蟲感染與其對化學試劑反應之研究

Human Intestinal Blastocystis Hominis Infection and Reaction with Chemical Reagent

葉啟松(Chi-Sung Yeh)

《北市醫學雜誌》 4卷4期 (2007/04) Pp. 310-320

https://doi.org/10.6200/TCMJ.2007.4.4.07

摘要

目的：探討本院區本科在腸道寄生蟲檢查陽性者以人芽囊原蟲(Blastocystis hominis)佔第一位，和國內多位學者所著論文差距頗大，但與國外文獻大致雷同；並進一步了解此蟲體在強酸、強鹼、酮類、醇類等之作用下其型態有何影響。方法：於民國九十四年九月至九十五年九月間，在醫師所開立的寄生蟲濃縮法檢驗單，利用張氏糞便檢查收集器(CFEA)收集本院之體檢部、病房、門診、附近之安養院、本院附設北投及士林門診部之糞便，不分職業、國籍、性別，以Merthiolate Iodine Formaldehyde(MIF)作業標準程序完成之，然後取沉澱物鏡檢；在化學試劑之作法，取最近的日期且含大量B. hominis蟲體之標本，不拘其型態並作成多量之懸浮液，各取等量之懸浮液與6N HCI、40% NaOH、95%酒精、100%丙酮、蒸餾水、100% acetic acid作用於試管內混合靜置30分鐘後，各吸一滴於玻片上鏡檢之。結果：共收集2561例（已扣除複檢24例）當中348例有寄生蟲感染，平均陽性率為13.6%，有12種寄生蟲感染，其中種類以B. hominis佔第一位共318例（包括47例之混合感染例），陽性率為12.4%（如單指寄生蟲感染陽性者348例中，B. hominis陽性率即佔91.4%），包括外國人士257例，台籍31例，大陸籍25例，不名人士5例，且以印尼籍感染率最高有91例，佔28.6%，其次為越南籍84例，佔26.4%；另外無論何種型態之B. hominis與各種化學試劑作用下，皆不能改變其型態。結論：與國內多篇文獻比較如：彭氏等18.0%（鉤蟲7.6%），王等40.7%（泰國肝吸蟲28.0%），盧成皆15.4%（泰國肝吸蟲7.4%），李金木17.4%（鞭蟲5.4%），徐玲玉25%（泰國肝吸蟲10.1%），鍾文政14%（泰國肝吸蟲5%），顏全敏18.5%（泰國肝吸蟲7.1%），盧盡良19.3%（泰國肝吸蟲5.2%），呂森吉7.9%（鞭蟲2.6%）等，由以上（佔第一位蟲體及陽性率）顯然差異頗大，或許此蟲體當時被認為較少出現症狀及感染性，且本人多年研究B. hominis多泡型、無空泡型最易誤判為胞子或雜物，空泡型易誤判為不同型態酵母菌，如今檢驗報告有此蟲體屬於異常，須藥物治療及複檢，因此不能輕視，且B. hominis在各種化學試劑作用下其型態也不能改變，表示細胞膜對外來物抵抗性甚強。

關鍵字

人芽囊原蟲 ； 腸道寄生蟲 ； 化學試劑反應

並列摘要

Background and Purpose: To explored the high incidence of human intestinal Blastocystis hominis infection to represent in medical laboratory of Yang Ming Branch, Taipei City hospital. The reaction of chemical reagents with Blastocystis homins for observating parasite morphology. Methods: Since september 2005 to september 2006, used Chang, s feces examination apparatus (CFEA), there were 2561 feces collected with CFEA from different department of Yang Ming Branch, Taipei City hospital. Prepared Merthiolate Iodine Formaldehyde (MIF) mixture 4cc (MF: Iodine=15:1) was added into CFEA and mixed stool with stick, let it standing for 4 hours at least, After centrifuge 1500 rpm 5 minutes,To observed parasite from sediment by microscope in 100X and 400X. MIF was added again in the B. hominis positive specimens, then (1) 6 NHCl, (2) 40%NaOH, (3) 95%alcohol, (4)100%acetone, (5) Distilled water (6) 100%acetic acid, was added seperately into the resuspended B. hominis specimen, 30 minutes later, the microscopically morphologic alteration of B. hominis was observed. Result: Among the 2561 specimen 348 specimen (incidence 13.6%) was infected with parasite, B. hominis was predominant in 318 specimens (The case of B. hominis account for 91.4% among the 384 parasite infected case). Indonesian has the highest infected rate. B. hominis has no change in morphology after mixed with chemical reagent. Conclusion: comparison with the articles in Taiwan, All of the results were conflict with this study, but this study is compatible with other jounals published overseas. B. hominis has no morphologic change with chemical reagent, obviously B. hominis could resisted any surrounding materials.

並列關鍵字

Blastocystis hominis ； Intestinal parasite ； Chemical reaction