摘要目的 了解遵义当地结膜吸吮线虫病的流行特征、虫体形态及18S rRNA基因序列.方法 收集2011-2015年遵义医学院附属医院和遵义市航天医院眼科来自遵义当地及周边结膜吸吮线虫人体感染标本及感染病例临床资料,分析感染者性别、年龄、居住地及家养猫、狗等情况对发病的影响.光镜下观察雌、雄虫形态特征;对线虫标本进行18S rRNA基因PCR扩增,产物序列应用MEGA 7.01软件邻接法进行遗传进化分析及与上传美国国家生物信息中心(NCBI)基因库的基因进行比对.结果 共收集当地结膜吸吮线虫人体感染病例25例,资料完整22例.结膜吸吮线虫人体感染总体呈上升趋势,其中2011年2例(9.1%),2012年1例(4.5%),2013年3例(13.6%),2014年10例(45.5%),2015年6例(27.3%).每年8-11月为高发期,5年共有15例感染,发病人群主要是农民或农民工(20例);发病不受年龄限制,年龄最小8.5个月,最大77岁,30~60岁患者居多(8例);女性多于男性,分别为16、6例;7例患者家中养有狗、猫.光镜下,结膜吸吮线虫体表边缘锐利呈锯齿状,雄虫尾端较尖、向腹面卷曲,有长短交合刺各1根;雌虫尾端较钝,子宫内含幼虫和虫卵.结膜吸吮线虫18S rRNA基因序列与基因库中日本上传的结膜吸吮线虫(AB538282.1)同源性为100%;系统发育分析显示亲缘关系较近,可聚为一支.结论 遵义当地及周边人体感染结膜吸吮线虫病例总体上呈逐年增多态势,发病人群主要是农民或农民工.结膜吸吮线虫18S rRNA基因序列与AB538282.1同源性较高,根据虫体形态及18S rRNA基因序列和遗传特征,临床上有利于虫种的鉴定及流行病学特征分析.

abstractsObjective To study epidemiological characteristics of thelazjasis, in Zunyi and surrounding areas, morphology and 18S rRNA gene sequence of Thelazia callipaeda. Methods The Thelazia callipaeda was collected from several hospitals, including affiliated Hospital of Zunyi Medical College and Zunyi Aerospace Hospital, in Zunyi region since 2011 to 2015. Clinical data of infected human thelaziasis, including the patients' gender, age, residence and pets such as cats or dogs, were analyzed to find out the factors influencing the incidence. Morphology characteristics of female and male Thelazia callipaeda were observed under microscope. 18S rRNA gene of Zunyi Thelazia callipaeda was amplified by PCR, and the evolutional relationship was analyzed through the software MEGA 7.01 based on neighbour-joining (NJ) method. Homology was campared with 18S rRNA gene from GenBank in National Center of Biotechnology. Results Totally 25 cases had been reported during the study, of which 22 cases had more details. Based on the cases, we found the thelaziasis was increasing year by year. For instance, 2 cases (9.1%) were reported in 2011, 1 case (4.5%) in 2012, 3 cases in 2013 (13.6%), 10 cases (45.5%) in 2014 and 6 cases (27.3%) in 2015 . During the five years , totally 15 cases were treated between August and November, when the human thelaziasis was in typical epidemic peaks. We analyzed characteristics of the total cases reported to date. Most of the cases occurred in rural areas (20 cases). Majority of patients lived in rural region. And most cases were between 30 to 60 years old, indicating no age limit, especially, there were two cases who were at the ages of 8.5 months and 77 years old, respectively. Moreover, more women suffered from the disease than that in men, of which, the case number was 16 in women and 6 in men, and there were 7 cases who had cats or dogs at home. Under light microscope, the edge of Thelazia callipaeda had serrated cuticle with transverse striations. And male worm had a sharp peak at the tail end of Thelazia callipaeda, which cured to the ventrite and had two copulatory spicules, long one and short one, respectively. While female worm had a blunt tail, containing numerous eggs and rounded first-stage larvaes in a single line in the distal area of the uterus, near the vulva. Sequences of Thelazia callipaeda 18S rRNA gene from Zunyi and Oita Japan (AB538282.1) were showed homology of 100%, and they were clustered in a same branch of Phylogenetic tree. Conclusions Human thelaziasis cases in Zunyi region are increasing each year, and most of the cases have occurred in rural areas. 18S rRNA gene has a high homology with sequence AB538282.1 in Thelazia callipaeda. Combining clinical data, analysis of epidemiological characteristics and the characteristics of 18S rRNA should be good for specie identification and epidemiological analysis.