CAJ | 학술논문

目的了解胆囊结石中是否存在华支睾吸虫卵,探讨华支睾吸虫卵与胆囊结石的关系.方法 2011年3至8月间对183例患者的胆囊结石进行研究,用磨碎镜检和FTIR光谱分析法分析结石,并随机抽取光镜镜检虫卵阳性结石和虫卵阴性结石各20例进行实时荧光PCR检测胆囊结石华支睾吸虫卵DNA并行扫描电镜观察.结果 183例胆囊结石中有118例检出虫卵,光镜下虫卵的形态特征符合华支睾吸虫卵.实时荧光PCR检测结果证实,胆囊结石中虫卵为华支睾吸虫虫卵.118例虫卵阳性结石中97例为胆色素型结石,21例为混合型结石,未见胆固醇型结石.在三种类型的结石中,胆色素型结石的华支睾吸虫卵检出率最高(P＜0.001).对20例虫卵阳性结石行扫描电镜观察:400倍下,视野中可见几十个甚至上百个华支睾吸虫卵；1000倍下,可见十几个甚至几十个华支睾吸虫卵与周围颗粒相互粘附、包裹；3000倍下,可见虫卵表面布满纹理,部分虫卵表面纹理脱落或变形呈表面凹陷状,部分虫卵卵盖丢失,大部分虫卵被无定形颗粒或黏液样物质包裹.结论胆囊结石中检出大量华支睾吸虫卵；华支睾吸虫卵与胆囊结石尤其胆色素型结石的形成有关.
목적 료해담낭결석중시부존재화지고흡충란,탐토화지고흡충란여담낭결석적관계.방법 2011년3지8월간대183례환자적담낭결석진행연구,용마쇄경검화FTIR광보분석법분석결석,병수궤추취광경경검충란양성결석화충란음성결석각20례진행실시형광PCR검측담낭결석화지고흡충란DNA병행소묘전경관찰.결과 183례담낭결석중유118례검출충란,광경하충란적형태특정부합화지고흡충란.실시형광PCR검측결과증실,담낭결석중충란위화지고흡충충란.118례충란양성결석중97례위담색소형결석,21례위혼합형결석,미견담고순형결석.재삼충류형적결석중,담색소형결석적화지고흡충란검출솔최고(P＜0.001).대20례충란양성결석행소묘전경관찰:400배하,시야중가견궤십개심지상백개화지고흡충란；1000배하,가견십궤개심지궤십개화지고흡충란여주위과립상호점부、포과；3000배하,가견충란표면포만문리,부분충란표면문리탈락혹변형정표면요함상,부분충란란개주실,대부분충란피무정형과립혹점액양물질포과.결론 담낭결석중검출대량화지고흡충란；화지고흡충란여담낭결석우기담색소형결석적형성유관.
Objective To study whether Clonorchis sinensis eggs were involved in the pathogen esis of gallbladder stones.Method From March to August 2011,the gallbladder stones from 183 patients were studied using microscopic examination and FTIR spectroscopy.Twenty egg-positive and 20egg-negative gallbladder stones found under microscopic examination were chosen randomly and analyzed through real-time fluorescent PCR and scanning electron microscopy.Results Eggs were detected in 118 of 183 gallbladder stones.The eggs were preliminarily diagnosed as Clonorchis sinensis eggs using the morphologic characteristics under light microscope.The results of real-time fluorescent PCR showed eggs in the gallbladder stones were Clonorchis sinensis eggs.The 118 egg-positive gallbladder stones were composed of 97 pigment stones,21 mixed stones and no cholesterol stones.The detection rate of Clonorchis sinensis eggs in pigment stones were the highest among the three types of gallbladder stones (P＜0.001).The 20 egg-positive stones were observed by scanning electronic microscopy:dozens or even hundreds of Clonorchis sinensis eggs were visible under 400 times magnification; and a dozen or even dozens of Clonorchis sinensis eggs and the surrounding particles were adherent to or parceled with each other under 1000 times magnification.While under 3000 times magnification,uneven texture was seen on the surface of eggs with pieces being shed from some eggs.Some eggs were hollow or without cover.Most of them were adherent to or wrapped with amorphous particles or mucoid matter.Conclusions A large amount of Clonorchis sinensis eggs were detected in gallbladder stones.Clonorchis sinensis eggs were associated with the formation of gallbladder stones,especially with pig ment stones.