寄生虫感染致外周血嗜酸性粒细胞增多的临床特点

摘要

Objective To identify the clinical features of eosinophilia caused by parasitic infection . Methods We reviewed and analyzed the clinical characteristics, peripheral eosinophils count, species of parasites, and system involvement of 87 patients with parasitic infections who were diagnosed and admitted in Peking Union Medi-cal College Hospital (PUMCH) between January 2010 and December 2014.Results Of the 87 patients with parasitic infections, increased count of peripheral eosinophils occurred in 33.3%(29/87) patients, and hypereosinophilia with eosinophil count over 1.5 ×109/L in 14.9% (13/87) patients.Paragonimus westermani (100%), Schistosoma (83.3%), and Clonorchis sinensis (57.1%) were the three most common parasites leading to eosinophilia .The infected patients with pulmonary and digestive system involvement were more likely to develop eosinophilia , with the proportion of patients having eosinophilia being 85.7%and 50.0%, respectively, and the proportion of patients having hypereosinophilia being 28.6%and 33.3%, respectively.Conclusions The percentage of patients having eosinophilia among those with parasitic infections may vary with the species of parasites and in -volved organ .The differential diagnosis in hypereosinophilia should consider the possibility of parasitic infection .%目的：总结寄生虫感染患者外周血嗜酸性粒细胞的临床变化特点。方法北京协和医院2010年1月至2014年12月收治并明确诊断为寄生虫感染的患者87例，收集其临床资料，回顾性分析患者外周血嗜酸性粒细胞与感染寄生虫种类及临床受累系统的相关情况。结果87例寄生虫感染患者中，33.3％（29／87）的患者外周血嗜酸性粒细胞绝对计数升高，14.9％（13／87）的患者绝对计数明显升高（＞1.5×109／L）。卫氏并殖吸虫（100％）、血吸虫（83.3％）及华支睾吸虫（57.1％）是引起外周血嗜酸性粒细胞比例升高的最常见三种寄生虫。呼吸系统和消化系统受累后出现外周血嗜酸性粒细胞比例升高最为常见，出现嗜酸性粒细胞比例升高的患者分别占85.7％及50.0％，出现嗜酸性粒细胞绝对计数明显升高的患者分别占28.6％及33.3％。结论寄生虫感染患者中，出现外周血嗜酸性粒细胞升高的患者比例随感染寄生虫种类或主要受累脏器部位不同而有所不同。当遇到高嗜酸细胞血症患者时，应注意寄生虫感染的鉴别诊断。