간의 기생충 질환 - kasl.org

1 40 Parasitic Diseases of the Liver .. (Protozoa) Leishmania donovani, Trypanosoma cruzi, Entamoeba histolytica, Toxoplasma gonii, Plasmodium falciparum, Pneumocystis cainii, Balantidium coli, Cryptosporidium, (Nematoda) Strongyloides stercoralis, Ascaris lumbricoides, Toxocara canis, Gnathostoma, Capillaria hepatica, (Trematoda) Fasciola hepatica, Clonorchis sinensis, Opisthorchis viverinii, Schistosoma japonicum, mansoni, (Cestoda) Sparganum, Echinococcus granulosus, multilocularis . (Clonorchis sinensis) (Opisthorchis viverrini) (Clonorchis sinensis) . 140 4.

2 1 (Opisthorchis viverrini) International Agency for Research on Cancer (IARC) 2 1999 10% ( , ) 2005 , . 2001 2005 10%( 12%, 6%) . , 50 . praziquantel .3 Parasitic Diseases of the Liver411. (Morphology) (Life cycle) . , . mm, mm, mm . 22-25 11-19 m , . (miracidium) . 2,400 , 1,100 , 4,000 , 330 , 2,000-4,000 .4,5.

3 1 (Parafossarulus manchouricus, Bulimus, Alocinma) . sporocyst, (redia) (cercaria) . 24-48 2 .. 2 . (metacercariae) .. (bile ductule) , 1 . 20-30 . (gall bladder), .4-6 (Pseudorasbora parva), , , , , , . 50 C 5 , 70 C 30 , 98 C 20 , 6 , 6 . 25 , 19 , 530 , 48 , , , 6.

4 6,7 , 1/2 .2. (Pathophysiology) (Clinical manifestation) , , ( ) . 2012 Single Topic Symposium42 , . (epithelial hyperplasia), , . , , , , . (goblet cell metaplasia), (adenomatous hyperplasia) 5,6 , .. , , , , , , , . , .8 (biliary cirrhosis) (cholangiocarcinoma).

5 2-3 . , , .9 5-10% , , , . , .53. (Diagnosis) . , , .1) . (Kato-Katz method, Formalin ether concentration technique) , Parasitic Diseases of the Liver43.

6 DNA PCR ..10,112) , . (ELISA) .. (crude extracts) (excretory -secretory antigens) .10,11 7 kDa , lysophosphatidic acid phosphatase, 28 kDa , Myoglobin, Clonorin , 26 kDa 28 kDa glutathione S-transferases , . cysteine ( ) ( ) .123) (RDT, Rapid Diagnostic Test).

7 RDT 5 L . RDT (colloidal gold particle) (tracer antigen) . nitrocellulose (micro-pore) protein A .. RDT ELISA 91% . ELISA , RDT 90% .132012 Single Topic Symposium444) (76%) . , ( 10 mm ) .84. (Treatment) (Prevention) Pyrazinoisoquinoline praziquantel 25 mg/kg 5 1 3 83-85% . praziquantel 40-50 mg/kg 1 91-97% . praziquantel.

8 4 .5 , , , ammonium sulfate , 1 , , .4 (Fasciola hepatica)De Brie(1379) Leukert(1883) . , ( , , , , , ) , . , .4,51. (Morphology) (Life cycle) . (cephalic cone) . spine 20-30 8-13 mm . , . 2 .. 130-150 63-93 m . 10 .4 , 9-10 . 24 1 Lymnaea ollula, Parasitic Diseases of the Liver45 Lymnaea tranculata, L.

9 Pervia, sporocyst, , (5-7 ). (aquatic vegetation) (metacercariae) 2 . (watercress), (alfalfa) , , . , . , 6 , , , , 25,000 .5 , , , , .142. (Pathophysiology) (Clinical manifestation)1) (acute and invasive phase) mm 2 3-5 , , , , , , , , , , , , , . , LDH 4 . , , , , ..5,8,142) (chronic phase).

10 , , . 6 10 . , spine .8 , , , . , , , , , GGT . GGT alkaline phosphatase . GGT 9 18 .14,15 50% . , cathepsin L1 .162012 Single Topic Symposium463. (Diagnosis) .1) (1) Fas2-ELISA(cathepsin L1-based antibody) , , 16 tricla-bendazole 3-5.