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<h2 class="title">蚊類傳播的疾病</h2> <div id="rqr52swi" class="sub-info">發(fā)布時間：2020年10月23日閱讀次數(shù)：1021</div> <p>一.瘧疾<br/>　　瘧疾原為熱帶和亞熱帶地區(qū)的一種嚴(yán)重疾病，現(xiàn)已廣泛傳播。病因是瘧原蟲，通過蚊蟲的叮咬進(jìn)入到人體的血液而引起發(fā)病，瘧疾中最嚴(yán)重類型是惡性瘧熱型瘧疾瘧疾通過按蚊叮咬吸血時傳播，多發(fā)生于夏秋季節(jié)。瘧疾多發(fā)生在兒童身上，病人的發(fā)病癥狀通常表現(xiàn)為發(fā)冷發(fā)抖，繼而出現(xiàn)高熱、面色潮紅、頭痛、口渴、全身酸痛。接著就是全身大汗、體溫很快降至正常。嚴(yán)重者可有劇烈頭痛、精神錯亂、抽搐、昏迷、大小便失禁等癥狀。瘧疾通過按蚊叮咬吸血時傳播，多發(fā)生于夏秋季節(jié)。瘧疾多發(fā)生在兒童身上，瘧疾的癥狀通常表現(xiàn)為發(fā)冷發(fā)抖，繼而出現(xiàn)高熱、面色潮紅、頭痛、口渴、全身酸痛。接著就是全身大汗、體溫很快降至正常。嚴(yán)重者可有劇烈頭痛、精神錯亂、抽搐、昏迷、大小便失禁等癥狀。瘧疾在感染6—30天內(nèi)開始出現(xiàn)癥狀，但由于抗瘧疾藥品的使用，且部分地投發(fā)揮作用，潛伏期可長達(dá)一年。瘧疾的癥狀主要包括：<br/>　　1、高燒和間歇性的寒顫。<br/>　　2、頭痛。<br/>　　3、惡心、嘔吐。<br/>　　4、腹背疼痛。<br/>　　5、關(guān)節(jié)疼痛。<br/>　　惡性瘧熱型瘧疾能引起嚴(yán)重的并發(fā)癥，并波及腎、肝、腦和血液。<br/>二.絲蟲病<br/>　　絲蟲病是指絲蟲(由吸血節(jié)肢動物傳播的一類寄生性線蟲)寄生在脊椎動物終宿主的淋巴系統(tǒng)、皮下組織、腹腔、胸腔等處所引起的疾病。　　兩種絲蟲引起絲蟲病的臨床表現(xiàn)很相似，急性期為反復(fù)發(fā)作的淋巴管炎、淋巴結(jié)炎和發(fā)熱，慢性期為淋巴水腫和象皮腫，嚴(yán)重危害流行區(qū)居民的健康和經(jīng)濟(jì)發(fā)展。 <br/>我國流行的只有班氏絲蟲(Wuchereria bancrofti)和馬來絲蟲(brugia malayi)。馬來絲蟲主要寄生在上、下肢的淺表淋巴系統(tǒng)，尤以下肢為多，故以四肢癥狀多見; 班氏絲蟲除寄生在淺表淋巴系統(tǒng)外，多寄生于深部淋巴系統(tǒng)中，如下肢、陰囊、精索、腎盂等部位，常出現(xiàn)泌尿系統(tǒng)癥狀。<br/>　　絲蟲病的發(fā)病和病變主要由成蟲及傳染期幼蟲引起。傳染期幼蟲經(jīng)蚊叮咬侵入人體后，在淋巴系統(tǒng)內(nèi)發(fā)育成為成蟲。當(dāng)雌雄蟲體交配后，雌蟲即產(chǎn)生微絲蚴，成絲狀活動。微絲蚴自淋巴系統(tǒng)進(jìn)入血液循環(huán)，一般白天藏匿于肺的微血管內(nèi)，夜間進(jìn)入周圍血液循環(huán)，具有明顯的夜周期性。通常馬來微絲蚴為晚8時至次晨4時，斑氏微絲蚴為夜晚10時至次晨2時。<br/>　　絲蟲病的病變在淋巴管和淋巴結(jié)，由成蟲的機(jī)械刺激或死后蟲體分解產(chǎn)物的化學(xué)刺激，引起一系列反應(yīng)性病變。<br/>　　1、急性期表現(xiàn)為滲出性炎癥，淋巴結(jié)充血、淋巴管壁水腫，嗜酸性粒細(xì)胞浸潤，纖維蛋白沉積。淋巴管和淋巴結(jié)內(nèi)逐漸出現(xiàn)增生性肉芽腫反應(yīng)，肉芽中心為變性的成蟲和嗜酸性粒細(xì)胞，周圍有纖維組織和上皮樣細(xì)胞圍繞，并有大量淋巴細(xì)胞和漿細(xì)胞聚集，形成類結(jié)核結(jié)節(jié)。<br/>　　2、慢性期突出表現(xiàn)為大量纖維組織增生，蟲體鈣化，淋巴結(jié)變硬，淋巴管纖維化，形成閉塞性淋巴管內(nèi)膜炎。淋巴管的阻塞可致遠(yuǎn)端淋巴管內(nèi)壓增高，形成淋巴管曲張和破裂，淋巴液郁滯，淋巴管內(nèi)蛋白成分增加。阻塞位于皮下，淋巴液不斷刺激組織，使纖維組織大量增生，皮下組織增厚、變粗、皺褶，變硬形成象皮腫。阻塞位于深部淋巴系統(tǒng)，則出現(xiàn)陰囊象皮腫、淋巴腹水、乳糜腹瀉、乳糜尿等。由于局部血液循環(huán)障礙，易引起繼發(fā)感染使象皮腫加重及惡化，甚至形成潰瘍。<br/>三.流行性乙型腦炎<br/>　　流行性乙型腦炎(epidemic encephalitis B，簡稱乙腦)，是由嗜神經(jīng)的乙腦病毒所致的中樞神經(jīng)系統(tǒng)性傳染病。本病主要分布在亞洲遠(yuǎn)東和東南亞地區(qū)，經(jīng)蚊傳播，多見于夏秋季，臨床上急起發(fā)病，有高熱、意識障礙、驚厥、強(qiáng)直性痙攣和腦膜刺激征等，重型患者病后往往留有后遺癥。乙腦的病死率和致殘率都很高，屬于威脅兒童健康的主要傳染病之一。夏秋季是乙腦的發(fā)病高峰季節(jié)，流行地區(qū)分布與媒介蚊蟲分布密切相關(guān)。部分患者留有嚴(yán)重后遺癥，重癥患者病死率較高。乙腦病原體1934年在日本發(fā)現(xiàn)，故名日本乙型腦炎，1939年我國也分離到乙腦病毒，解放后進(jìn)行了大量調(diào)查研究工作，改名為流行性乙型腦炎。 <br/>　　當(dāng)人體被帶乙腦病毒的蚊蟲叮咬后，病毒經(jīng)皮膚毛細(xì)血管或淋巴管至單核巨噬細(xì)胞系統(tǒng)進(jìn)行繁殖，達(dá)到一定程度后即侵入血循環(huán)，造成病毒血癥，并侵入血管內(nèi)膜及各靶器官，如中樞神經(jīng)系統(tǒng)、肝、心、肺、腎等，引起全身性病變。發(fā)病與否主要取決于人體的免疫力及其他防御功能，如血腦屏障是否健全等。若腦部患有囊蟲病時可以促進(jìn)腦炎的發(fā)生，病毒的數(shù)量及毒力對發(fā)病也能起一定作用，且對易感者臨床癥狀的輕重有密切關(guān)系。機(jī)體免疫力強(qiáng)時，只形成短暫的病毒血癥，病毒很快被中和及消滅，不進(jìn)入中樞神經(jīng)系統(tǒng)，表現(xiàn)為隱性感染或輕型病例，但可獲得終身免疫力;如受感染者免疫力低，感染的病毒量大及毒力強(qiáng)，則病毒可經(jīng)血循環(huán)通過血腦屏障侵入中樞神經(jīng)系統(tǒng)，利用神經(jīng)細(xì)胞中的營養(yǎng)物質(zhì)和酶在神經(jīng)細(xì)胞內(nèi)繁殖，引起腦實質(zhì)變化。若中樞神經(jīng)受損不重，則表現(xiàn)為一過性發(fā)熱;若受損嚴(yán)重，神經(jīng)系統(tǒng)癥狀突出，病情亦重。<br/>四.登革熱<br/>　　登革熱(dengue fever)是由伊蚊傳播登革病毒(dengue virus)引起的急性傳染病。主要通過埃及伊蚊或白紋伊蚊為媒介進(jìn)行傳播。其特點為急性起病，發(fā)熱，全身肌肉、骨、關(guān)節(jié)痛，極度疲乏，皮疹，淋巴結(jié)腫大及血液白細(xì)胞、血小板減少。 <br/>　　登革病毒經(jīng)伊蚊叮咬進(jìn)入人體后在毛細(xì)血管內(nèi)皮細(xì)胞和單核巨噬細(xì)胞系統(tǒng)內(nèi)復(fù)制，然后進(jìn)入血液循環(huán)，形成第一次病毒血癥。定位于單核巨噬細(xì)胞系統(tǒng)和淋巴組織中的登革病毒繼續(xù)進(jìn)行復(fù)制，再次釋入血流形成第二次病毒血癥，并引起臨床癥狀與體征。機(jī)體產(chǎn)生的抗登革病毒抗體與登革病毒形成免疫復(fù)合物，激活補(bǔ)體系統(tǒng)，導(dǎo)致血管的通透性增加，亦可導(dǎo)致血管水腫和破裂。登革病毒的復(fù)制可抑制骨髓中白細(xì)胞和血小板的再生，導(dǎo)致白細(xì)胞、血小板減少和出血傾向。<br/>　　病理改變表現(xiàn)為肝、腎、心和腦等器官的退行性變，出現(xiàn)心內(nèi)膜、心包、胸膜、腹膜、胃腸黏膜、肌肉、皮膚及中樞神經(jīng)系統(tǒng)不同程度的水腫和出血。皮疹活檢可見小血管內(nèi)皮細(xì)胞腫脹、血管周圍水腫及單核細(xì)胞浸潤，瘀斑中有廣泛性血管外溢血。腦膜腦炎型患者可見蛛網(wǎng)膜下腔和腦實質(zhì)灶性出血、腦水腫及腦軟化。重型患者可有肝小葉中央灶性壞死及淤膽，小葉性肺炎和間質(zhì)性肺炎等。</p> </article> <div id="rqr52swi" class="article-relative"> <div id="rqr52swi" class="col-xs-6">< 上一篇：<a href="/wiki/info_118.html" title="蠅類與蟑類傳播的疾病">蠅類與蟑類傳播的疾病</a></div> <div id="rqr52swi" class="col-xs-6 text-right">下一篇：<a href="/wiki/info_115.html" 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