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KMID : 0438219770140010057
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Korea University Medical Journal
1977 Volume.14 No. 1 p.57 ~ p.76
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Comparative studies on the clinical hematology and biochemistry in the various parasitic infections
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玄逸/Hyun, Il
林漢鍾/Rim, Han-Jong
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Abstract
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To observe the specific clinical blood values in the various parasitic infections, the following examinations were performed on 438 cases (330 males and 108 females in all ages) who were infected by various parasites in all degrees of infection: clinical hematologyhemoglobin, hematocrit, red blood cell count, white blood cell count, differential count and blood platelets countand blood biochemistrytotal protein, albumin, cholesterol, bilirubin, alkaline phosphatase, SGOT, SGPT, thymol turbidity test (TTT) and blood urea nitrogen (BUN). All the calculated mean values for each items with standard deviation in each parasitic infections were compared with those of the tables of normal blood values of Halsted (1976). The studies reported here were undertaken at different times from 1973 to 1975 in various rural and urban areas in Korea.
Results obtained are as follows:
1. The relative frequency of each parasites is as follows: 309 cases (70.6%) of Trichuris frichiura, 217 (49.5%) As.;aris lumbricoidcs, 169 (38.6%) Clonorchis sinensis, 135(30.8%) hookworm, 29 (6.6%) Enterobius vermicularis, 28 (6.4%) Entamoeba histolytica, 21 (4.8%) Trichostrongylus orientalis, 6 (1.4%) Taedia sp. and 1 (0.2%) Metagonimus yokogawai infection. Looking at the incidence of polyparasitism, only 15.3% were infected with a single infection and 27.1% of double infestation, 42.6% of triple infestation, 12.8´0 of quadruple infestation and 2.1% were quintuple infestation.
2. The EPG (eggs per gram of feces) of each parasitic infections were determined by Stoll´s egg counting method. The mean EPG of 217 cases of A. lumbricoidcs infection was 7,09710,074 regarded as moderate degree of infection, but the age group of 59 showed the highest mean EPG of 19,13322,263 regarded as heavy degree of infection. The mean EPG of 169 cases of Clonorchis sinensis infection was 20,45924.,880 regarded as heavy degree of infection. On the other hand, the mean EPG of 135 cases of hookworm infection and 309 cases of T. trichiura infection were
491937 and 420607 respectively. These were regarded as light degree of infection. However, the degrees of infection were not analysed in the cases of paragonimiasis and amoebiasis.
3. There is no any pathological mean values of clinical hematology in the various parasitic infections with the exception of moderate eosinophilia (109%)
4. There is no any pathological mean values of blood biochemistry in the various parasitic infections with the exception of slight elevation of alkaline phosphatase (5.44.6 unit).
5. In the intestinal nematodes infection group including A. lumbricoides, hookworm and T. trichiura infection cases, all the clinical laboratory values were within the normal limit except moderate eosinophilia and slight elevation of alkaline phosphatase.
6. In clonorchiasis cases, there is a significant change in the clinical laboratory values. The high eosinophilia (1411%) was shown in 165 cases and the values of alkaline phosphatase, SGOT and SGPT were upper margin or slightly higher than the normal values.
7. In paragonimiasis cases, the mean values of hemoglobin, hematocrit and red blood cell counts were the lowest margin or slightly lower than the normal values. Slight eosinophilia was also shown in this cases.
& In amoebiasis cases, the mean values of hemoglobin, hematocrit and red blood cell counts were lower than the normal values and the mean values of eosinophils, alkaline phosphatase, SGOT and SGPT were upper margin of the normal values.
9. The changes of hematological values by means of intensity of infection were analysed in the groups of C. sinensis, A. lumbricoides, hookworm and T. trichiura infection. In clonorchiasis it was indicated that the mean values of hematocrit. RBC count and WBC count are elevated by the higher intensity of infection, But all these values were within the normal values. Eosinophils was also elevated by the higher intensity of infection, on the contrary the counts of neutrophils and monocytes were seen tendency of decrease by the higher intensity of infection. In ascariasis, there is no any changes of the hematological values by the intensity of infection except eosinophils. In hookworm and T. trichiura infection groups, however, the mean values of hemoglobin, hematocrit and red blood cell count were lowered by the higher intensity of their infection. Therefore, anemia signs were shown-evidently in the heavy infection.
10. The changes of blood biochemical values by means of intensity of the above four infections were analysed. In Clonorchis infecion, the mean values of albumin were lowered and the A/G ratio were reversed by the higher intensity, and also the mean values of alkaline phosphatase, SGOT and SGPT were remarkably elevated by the higher intensity of infection. With these results, it is possibly recognized as a partial obstruction of bile ducts by the large numbers of Clonorchis worms. On the other hand, there were no any changes on the blood biochemical values by the intensity of infection of A. lumbricoides, hookworm and T. trichiura.
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