本文選題：蜱 + 梨形蟲��； 參考：《中國疾病預防控制中心》2014年博士論文

【摘要】：梨形蟲是一類經蜱傳播的頂復門原蟲,廣泛分布于熱帶和亞熱帶地區(qū),對人畜均有較大危害。梨形蟲綱(Piroplasmea)包括巴貝科(Babesiidae)巴貝屬(Babesia)和泰勒科(Theileriidae)泰勒屬(Theileria)的多種原蟲,可引起動物巴貝蟲病(Babesiaosis)和泰勒蟲病(Theileriosis)。自然狀態(tài)下,巴貝蟲和泰勒蟲通過媒介蜱進行生物性傳播,故其地理分布與蜱的地理分布密切相關。大多數種類的巴貝蟲和泰勒蟲只對動物致病,我國家畜中巴貝蟲和泰勒蟲感染非常普遍,據調查在全國的12個省、自治區(qū)均有分布,嚴重威脅畜牧業(yè)發(fā)展。有少數巴貝蟲,如分歧巴貝蟲(B.divergens)和微小巴貝蟲(B.microti)對人也有較強的致病性。般認為,泰勒蟲對人沒有致病性,但是近年有少量研究報道顯示某些種類的泰勒蟲也可感染人類。人感染這類寄生蟲后的臨床癥狀主要表現為發(fā)熱、血紅蛋白尿、溶血性貧血等。 蜱是一類專營吸血的體外寄生蟲,目前全世界已經發(fā)現18個屬超過900種,中國目前已發(fā)現10個屬119種,包括100種硬蜱,10余種軟蜱。中國的蜱傳疾病在時空上分布不均,其中云南、甘肅、新疆、臺灣、福建等省區(qū)為中國蜱傳疾病的高發(fā)地區(qū)。由于蜱傳疾病的病原體種類很多,同一種病原體又可通過多種媒介蜱傳播,加上近些年來不斷有新的病原體出現,這都使得蜱傳疾病的傳播和流行變得更加復雜。 近些年來,我國蜱傳疾病的病例報道不斷增加,如臨床診斷錯誤或治療不及時很可能導致病人病情迅速惡化甚至死亡。2007年河南省信陽市報道了我國首例蜱叮咬致死事件,患者的主要癥狀為發(fā)熱、溶血性貧血等,當時由于病原體不明,造成了對患者診治的延誤。這也使得蜱傳疾病成為公眾關注的焦點。從2007年到2011年,河南省先后發(fā)現了1000例以上的病例,超過98%的報告病例來自于信陽地區(qū)。雖然當地不曾有人感染巴貝蟲的報道,但是部分患者的臨床癥狀與巴貝蟲感染癥狀非常相似。目前,我國對于巴貝蟲病和泰勒蟲病的傳播媒介以及流行特征的研究相對較少,對這一類新發(fā)人畜共患原蟲病的研究還不夠深入,所以對其潛在流行風險也知之甚少。所以,在信陽市對當地多種宿主開展巴貝蟲感染以及泰勒蟲感染的調查研究,以了解當地巴貝蟲病和泰勒蟲病的流行特征,為其預防和控制提供科學依據。 本研究首先于2012年4月至12月間,在信陽市轄區(qū)內隨機抽取10個調查點,開展了當地蜱種群和媒介蜱中梨形蟲感染調查。共從各種動物宿主(黃牛,水牛,羊,狗)體表采集到308只蜱,經形態(tài)學及分子生物學方法分析鑒定,發(fā)現298只蜱為長角血蜱(Haemaphysalis longicornis),10只為微小扇頭蜱(Rhipicephalus microplus)。經巢式PCR檢測、測序分析以及進化關系分析,在長角血蜱中檢測到巴貝蟲感染6例,泰勒蟲感染10例,同時鑒定出2種泰勒蟲(T. buffeli和T. luwenshuni)以及3種巴貝蟲(B. gibsoni, B. canis vogeli和B. microti)。在10個調查點中,共發(fā)現4個調查點(平橋區(qū),新縣,淮濱縣和固始縣)的媒介蜱中無梨形蟲感染,在4個調查點(羅山縣,息縣,潢川縣和商城縣)的媒介蜱中檢測到巴貝蟲感染,在2個調查點(mI河區(qū)和光山縣)的媒介蜱中檢測到泰勒蟲感染。研究結果顯示長角血蜱為當地的優(yōu)勢蜱種,同時也是梨形蟲的高效傳播媒介。 在完成媒介蜱中梨形蟲感染調查的基礎上,本研究又于2013年4月至12月間,再次隨機抽取5個調查點(平橋區(qū),mI河區(qū),羅山縣,息縣和商城縣)進一步開展了對信陽當地家養(yǎng)動物和野生動物中梨形蟲感染情況的調查。共采集各種動物(羊,牛,犬,雞和刺猬)血液樣本共531份。經實驗室檢測后發(fā)現當地動物中巴貝蟲感染的總陽性率為0.75%,泰勒蟲感染的總陽性率為32.58%。共在3個采樣點(商城縣,息縣,獅河區(qū))的宿主動物(羊和犬)中發(fā)現巴貝蟲感染,在4個采樣點(商城縣,平橋區(qū),羅山縣,mI河區(qū))的宿主動物(羊和刺猬)中發(fā)現泰勒蟲感染。同時鑒定出兩種巴貝蟲(B. microti和B. gibsoni),一種泰勒蟲(T. luwenshun)。o研究結果顯示呂氏泰勒蟲(T. luwenshuni)為當地動物中梨形蟲感染的主要種類,進化關系分析提示其與能感染人的泰勒蟲的遺傳進化關系非常相似。 在了解信陽地區(qū)動物中梨形蟲感染情況后,本研究立即在信陽當地開展了高危人群中梨形蟲感染情況調查。2013年6-10月間在商城縣,息縣和平橋區(qū)的調查點所在鄉(xiāng)衛(wèi)生院采集發(fā)熱門診病人或近期有蜱叮咬史并伴有發(fā)熱癥狀的病人的血液樣本共310份。經實驗室檢測共發(fā)現2例巴貝蟲感染病例,分別在商城縣和羅山縣各發(fā)現1例,經基因測序方法鑒定出微小巴貝蟲(B. microti)感染1例。 采用反向線點雜交(RLB)技術,檢測信陽地區(qū)發(fā)現的所有梨形蟲感染樣本是否存在多種梨形蟲的混合感染。結合調查所得各種宿主中梨形蟲感染數據以及收集的信陽當地生態(tài)地理數據和經濟學等數據,采用因素分析和多元Logistic回歸分析方法,對信陽當地多種宿主梨形蟲感染的影響因素進行分析。RLB實驗結果并未發(fā)現多種梨形蟲的混合感染,結果與巢式PCR實驗基本一致。單因素和多因素分析結果顯示,植被指數為影響多種宿主梨形蟲感染的共同影響因素。 綜合上述研究結果,本研究發(fā)現信陽當地多種宿主中均存在巴貝蟲和泰勒蟲感染。其中,媒介蜱、動物和高危人群中均檢測出微小巴貝蟲感染。媒介蜱和動物中均檢測到呂氏泰勒蟲感染,這些病原體對人和動物的影響還有待進一步研究。
[Abstract]:Pyriform worm is a kind of tick - transmitted apex protozoa, widely distributed in tropical and subtropical regions and has great harm to human and animal. Piroplasmea includes many protozoa of Babeko (Babesiidae) Babena (Babesia) and Telco (Theileriidae) Taylor (Theileria), which can cause the animal BABEI disease (Babesiaosis) and Taylor. Insect disease (Theileriosis). In natural state, the BABEI and Taylor worms are transmitted biologically through the medium ticks, so the geographical distribution is closely related to the geographical distribution of ticks. Most species of BABEI and Taylor are only pathogenic to animals. The infection of bberbeworm and Taylor in domestic animals is very common. According to the survey in 12 provinces and autonomous regions of the country A small number of BABEI worms, such as the B.divergens (B.divergens) and the tiny B.microti (B.microti), have a strong pathogenicity to people. It is believed that the Taylor worm is not pathogenic to humans, but in recent years a small number of studies have shown that some species of Taylor can also infect humans. The main clinical symptoms were fever, hemoglobinuria, hemolytic anemia and so on.
Ticks are an extracorporeal parasite specializing in blood sucking. At present, more than 900 species of 18 genera have been found worldwide. 10 genera and 119 species have been found in China, including 100 species of ticks and more than 10 species of soft ticks. In China, tick borne diseases are uneven in time and space, including Yunnan, Gansu, Xinjiang, Taiwan, Fujian and other provinces, which are the high incidence areas of tick borne diseases in China. Tick borne diseases have many kinds of pathogens, and the same pathogen can be transmitted through a variety of media ticks, coupled with the emergence of new pathogens in recent years, all of which have made the spread and epidemic of tick borne diseases more complicated.
In recent years, the case reports of tick borne diseases have been increasing in our country, such as the clinical diagnosis error or the untimely treatment may lead to the rapid deterioration of the patient's condition and even the death of the tick in the city of Xinyang, Henan province. The first case of the tick bite is reported in the city of Henan province. The main symptoms of the patient are fever, hemolytic anemia and so on. From 2007 to 2011, more than 1000 cases were found in Henan. More than 98% of the reported cases came from the Xinyang region. Although there were no reports of BABEI infection, the clinical symptoms of some of the patients were infected with the BABEI. Symptoms are very similar. At present, there are relatively few studies on the media and epidemic characteristics of BABEI and Taylor's diseases. The study of this kind of new zoonosis is not deep enough, so little is known about the risk of its potential epidemic. So, in Xinyang, a variety of local hosts are infected with BABEI. A survey of Taylor worm infection was conducted to understand the epidemiological characteristics of BABEI worm disease and Taylor worm disease in order to provide scientific evidence for its prevention and control.
In this study, from April 2012 to December, 10 survey sites were randomly selected from Xinyang area to investigate the infection of pyriform insects in local ticks and ticks. A total of 308 ticks were collected from various animal hosts (yellow cattle, buffalo, sheep and dogs), and 298 ticks were found to be long horned blood by morphological and molecular biological methods. Ticks (Haemaphysalis longicornis) and 10 only Rhipicephalus microplus. Through nested PCR detection, sequencing analysis and evolutionary relationship analysis, 6 cases of BABEI infection and 10 cases of Taylor worm infection were detected in chlorpyrifos, and 2 species of Taylor (T. buffeli and T. luwenshuni) and 3 species of BABEI (B. gibsoni, B.) were identified. S vogeli and B. microti). In 10 survey sites, 4 survey sites (Pingqiao, Xinxian County, Huaibin county and Gushi county) were found to have no pyriform infection in the media ticks, and BABEI insect infection was detected at 4 survey points (Luoshan County, Xixian County, Huangchuan county and Shangcheng County), and detected in the media ticks of 2 survey points (mI and Guangshan counties). Taylor worm infection. The results indicate that the blood ticks are the dominant species in the area, and they are also efficient vectors for the production of piriform worms.
On the basis of the investigation of the infection of pyriform insect in the media ticks, this study was conducted from April 2013 to December. 5 survey sites (Pingqiao District, mI river area, Luoshan County, Xixian County and Shangcheng County) were further investigated. The infection of pyriform insects in domestic domestic animals and wild animals in Xinyang was further carried out. A total of 531 blood samples were found in dogs, chickens and hedgehogs. After laboratory tests, the total positive rate of bBeetle infection was 0.75%, and the total positive rate of Taylor infection was found in the host animals (sheep and dogs) of 32.58%. in 3 sampling points (Shangcheng County, Xixian County, Shi River), and 4 sampling points (Shangcheng County, Pingqiao District, Luo). Taylor worm infection was found in the host animals (sheep and hedgehog) of mountain county, mI river area. Two species of BABEI (B. microti and B. gibsoni) were identified. The results of a Taylor (T. luwenshun).O study showed that the Taylor worm (T. luwenshuni) was the main species of pyriform infection in the local animals. Evolutionary relationship analysis suggested that it could infect people. The genetic evolution of the Taylor worm is very similar.
After understanding the infection of pyriform insects in the animals of Xinyang, this study immediately conducted a survey on the infection of pyriform insects in high risk population in Xinyang. In 6-10 months of.2013 in Shangcheng County, Xixian County and Pingqiao District, the township health centers collected fever outpatient or the blood of patients with the history of ticks and fever symptoms in the near future. A total of 310 samples were found. 2 cases of BABEI infection were found in the laboratory. 1 cases were found in Shangcheng County and Luoshan county respectively. 1 cases of small Babe (B. microti) infection were identified by gene sequencing.
Reverse line point hybridization (RLB) was used to detect the presence of a mixed infection of a variety of pear shaped worms in the Xinyang region. The data of the infection of pyriform insects in various hosts and the local eco geographic data and economics collected in Xinyang were analyzed by factor analysis and multiple Logistic regression. Analysis of the factors affecting the infection of pear shaped insects in Xinyang, the results of the.RLB experiment did not find a mixed infection of a variety of pyriform worms. The results were basically consistent with the nested PCR experiment. The results of single factor and multi factor analysis showed that the vegetation index was the common influence factor of the infection of various hosts of the host pear.
In this study, we found that there were BABEI and Taylor in various host hosts in Xinyang. Among them, both media ticks, animals and high risk populations detected the infection of bainiba. Both media ticks and animals detected the infection of Taylor. The effects of these pathogens on humans and animals were still to be further studied.
【學位授予單位】：中國疾病預防控制中心
【學位級別】：博士
【學位授予年份】：2014
【分類號】：R531

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