鐵(tie)線蟲(chong)(chong)(Gordiacea Von Stebold,1843)又名(ming)(ming)發(fa)形蛇(hair snake),亦(yi)稱毛細線蟲(chong)(chong)(hairworm)或戈(ge)爾迪烏斯線蟲(chong)(chong)(gordian worm),土名(ming)(ming)為銅絲(si)蛇或天絲(si)。
隸屬于(yu)線(xian)(xian)形動(dong)物(wu)門,為(wei)鐵(tie)(tie)(tie)線(xian)(xian)蟲(chong)(chong)(chong)(chong)綱蠕蟲(chong)(chong)(chong)(chong)的(de)總稱。與醫學(xue)有關(guan)的(de)蟲(chong)(chong)(chong)(chong)種(zhong)分(fen)屬于(yu)鐵(tie)(tie)(tie)線(xian)(xian)蟲(chong)(chong)(chong)(chong)目(Gordioidea)、鐵(tie)(tie)(tie)線(xian)(xian)蟲(chong)(chong)(chong)(chong)科(ke)(ke)(Gordiidae)、鐵(tie)(tie)(tie)線(xian)(xian)蟲(chong)(chong)(chong)(chong)屬(Gordius )和(he)索蟲(chong)(chong)(chong)(chong)科(ke)(ke)的(de)Chordodes, Paragordius和(he)Parachordodes屬等(deng),250~300種(zhong)。鐵(tie)(tie)(tie)線(xian)(xian)蟲(chong)(chong)(chong)(chong)體(ti)細長,馬鬃狀,長可達1米。成蟲(chong)(chong)(chong)(chong)在(zai)海(hai)水或淡水中自(zi)由生活,幼(you)蟲(chong)(chong)(chong)(chong)寄生在(zai)節肢(zhi)動(dong)物(wu)體(ti)內(nei)。國內(nei)分(fen)布于(yu)南(nan)北方各省,國外廣泛分(fen)布于(yu)世界各地。可通(tong)過水源(yuan)感染(ran)人體(ti),引起(qi)鐵(tie)(tie)(tie)線(xian)(xian)蟲(chong)(chong)(chong)(chong)病。在(zai)科(ke)(ke)研中,常(chang)作為(wei)動(dong)物(wu)學(xue)的(de)實驗(yan)材料。
鐵線蟲(chong)(chong)(chong)見于(yu)熱帶和(he)溫帶,在水中(zhong)營自由生(sheng)活,偶能感染人體(ti),寄生(sheng)于(yu)消化道(dao)內。成(cheng)蟲(chong)(chong)(chong)呈線狀,雌(ci)雄異體(ti),雌(ci)蟲(chong)(chong)(chong)在水邊產(chan)卵,以蚱蜢、蟑螂和(he)甲蟲(chong)(chong)(chong)等(deng)昆蟲(chong)(chong)(chong)為(wei)中(zhong)間宿(su)主。
大(da)型(xing)個體(ti)。體(ti)長為300-1000毫米,體(ti)型(xing)似細繩狀。與線蟲(chong)(chong)的(de)圓蟲(chong)(chong)類(lei)相(xiang)似,但無背線、腹線與側線。前(qian)端(duan)鈍圓,體(ti)表(biao)角質堅(jian)硬,雄(xiong)體(ti)末端(duan)分(fen)叉,呈倒 "V"字形,分(fen)叉部(bu)分(fen)的(de)前(qian)腹面為泄殖(zhi)孔。消(xiao)化(hua)管幼蟲(chong)(chong)期存在,而(er)成(cheng)(cheng)蟲(chong)(chong)期則(ze)退化(hua)。雄(xiong)體(ti)的(de)精巢和雌體(ti)的(de)卵巢數目多,成(cheng)(cheng)對排列(lie)于身體(ti)的(de)兩側。生(sheng)活時體(ti)呈深棕色。
成蟲(chong)棲息于河(he)流、池塘及(ji)水(shui)(shui)溝內(nei),雌體所(suo)產(chan)的(de)卵在水(shui)(shui)內(nei)孵出幼蟲(chong),被昆蟲(chong)或人(ren)類吃(chi)進后,通過(guo)寄生生活。當這種蟲(chong)被大型節肢動物如螳螂、蝗蟲(chong)等吞食后,幼蟲(chong)在這些(xie)節肢動物體內(nei)繼續發育,會逐漸控制宿(su)主(zhu)的(de)行為(wei),幼蟲(chong)成長為(wei)成蟲(chong)時,會控制宿(su)主(zhu)尋找(zhao)水(shui)(shui)源淹(yan)死宿(su)主(zhu)后從宿(su)主(zhu)體內(nei)鉆出。
人類很容易(yi)在水(shui)池里和不干(gan)凈(jing)(jing)的(de)水(shui)里喝到這些鐵(tie)線蟲(chong)的(de)幼蟲(chong),喝下去后有(you)一定幾率(lv)感染鐵(tie)線蟲(chong)病,這種病會(hui)使尿(niao)道感染發炎,所以池塘的(de)水(shui)和不干(gan)凈(jing)(jing)的(de)水(shui)不能隨便喝。幼蟲(chong)在節肢動(dong)物(wu)體(ti)(ti)內會(hui)誘使寄(ji)生體(ti)(ti)去尋找水(shui)源(yuan),所以水(shui)源(yuan)有(you)節肢動(dong)物(wu)尸體(ti)(ti)的(de)時候,不建議(yi)飲(yin)用。
成蟲在水(shui)中獨(du)自生活,偶爾(er)感染(ran)人體,引起(qi)鐵線蟲病(nematomorphiasis)。本病女(nv)性多于(yu)男性。
蟲(chong)體(ti)(ti)細長(chang),圓線形,似鐵絲,黑褐色(se);長(chang)約10~50cm,寬約1~3mm; 頭(tou)端鈍圓,具有0.5~1mm長(chang)的淡黃(huang)色(se)區;蟲(chong)體(ti)(ti)表(biao)面有許多(duo)小乳突;雄蟲(chong)尾部卷(juan)曲,末端分叉;雌(ci)蟲(chong)尾短尖鈍。蟲(chong)體(ti)(ti)在(zai)體(ti)(ti)外非(fei)常(chang)活躍,常(chang)有自行打結(jie)的習性。
鐵線蟲(chong)(chong)(chong)成蟲(chong)(chong)(chong)生(sheng)(sheng)活于沼澤(ze)、池塘、溪(xi)流、溝渠等(deng)水(shui)(shui)體(ti)(ti)中,雌雄交配產卵,卵內(nei)幼蟲(chong)(chong)(chong)孵出進入(ru)昆(kun)(kun)蟲(chong)(chong)(chong)(蚱蜢(locust)、蟋蟀(Cricket)、蟑螂(Cockroach)、甲(jia)蟲(chong)(chong)(chong)(Beetle)等(deng))體(ti)(ti)內(nei)發(fa)育形成稚(zhi)蟲(chong)(chong)(chong),昆(kun)(kun)蟲(chong)(chong)(chong)入(ru)水(shui)(shui),稚(zhi)蟲(chong)(chong)(chong)離開宿主在水(shui)(shui)中發(fa)育為成蟲(chong)(chong)(chong)。人體(ti)(ti)消化(hua)道(dao)感染鐵線蟲(chong)(chong)(chong)可能是(shi)通過接觸或飲用含有(you)稚(zhi)蟲(chong)(chong)(chong)的生(sheng)(sheng)水(shui)(shui)、昆(kun)(kun)蟲(chong)(chong)(chong)、魚類和(he)螺類或食物而引起。尿(niao)(niao)路(lu)感染是(shi)由于人體(ti)(ti)會(hui)陰部接觸有(you)鐵線蟲(chong)(chong)(chong)稚(zhi)蟲(chong)(chong)(chong)的水(shui)(shui)體(ti)(ti),經尿(niao)(niao)道(dao)侵(qin)入(ru),上行至膀胱內(nei)寄生(sheng)(sheng)。蟲(chong)(chong)(chong)體(ti)(ti)侵(qin)入(ru)人體(ti)(ti)后(hou)可進一步發(fa)育至成蟲(chong)(chong)(chong),并可存活數年。寄生(sheng)(sheng)泌(mi)尿(niao)(niao)道(dao)的患者(zhe),以女性為多,均有(you)明顯(xian)的泌(mi)尿(niao)(niao)道(dao)刺激(ji)癥,如下(xia)腹(fu)部劇(ju)烈疼痛、尿(niao)(niao)頻、尿(niao)(niao)急、尿(niao)(niao)痛、血尿(niao)(niao)、放射性腰痛、會(hui)陰和(he)陰道(dao)炎(yan)等(deng),蟲(chong)(chong)(chong)體(ti)(ti)排出后(hou),癥狀緩(huan)解。鐵線蟲(chong)(chong)(chong)寄生(sheng)(sheng)于消化(hua)道(dao)所引起的癥狀一般不明顯(xian),可有(you)消化(hua)不良(liang)、腹(fu)痛、腹(fu)瀉等(deng)表現(xian)。亦見有(you)從(cong)眼(yan)眶腫物或耳道(dao)檢出蟲(chong)(chong)(chong)體(ti)(ti)的報(bao)告。
診斷本(ben)病依據從尿中或糞便中檢(jian)獲(huo)蟲(chong)體。在臨床上若遇到有尿道(dao)刺激癥狀(zhuang),久治(zhi)不愈、而又(you)有生飲或會陰部接觸過塘、溝水或潮濕草地(di)的(de)患(huan)者,應考慮(lv)作膀胱鏡檢(jian)。
鐵線蟲(chong)病(bing)(bing)(bing)盡管(guan)是(shi)一種較為罕(han)見的(de)寄生(sheng)(sheng)蟲(chong)病(bing)(bing)(bing),全世界只有(you)14個國家有(you)病(bing)(bing)(bing)例(li)報道。但各地因生(sheng)(sheng)產生(sheng)(sheng)活接觸自然水(shui)體的(de)人群甚多,其實際(ji)感染人數(shu)可能遠(yuan)比已報告的(de)例(li)數(shu)要多。
防治本(ben)病的關(guan)鍵(jian)是(shi)不(bu)飲不(bu)潔(jie)之水、不(bu)生(sheng)(sheng)吃昆蟲、魚類和(he)螺類等食物,下(xia)水時避免下(xia)體與不(bu)潔(jie)水體直接接觸。疑有感染者(zhe)可口服驅蟲藥(yao)促(cu)蟲排出,寄生(sheng)(sheng)于組織內者(zhe)應(ying)手術取(qu)蟲。
遠離鐵線(xian)(xian)蟲疾病的(de)(de)(de)糾纏最好的(de)(de)(de)方法(fa)就是(shi)不要(yao)吃生(sheng)的(de)(de)(de)食物,魚類,以及螺類食物,這些(xie)都是(shi)不太衛生(sheng)的(de)(de)(de)食物。在飲食的(de)(de)(de)時候要(yao)注意看(kan)是(shi)否有與(yu)不干凈的(de)(de)(de)水體有關聯的(de)(de)(de)情況。而且,從臨床方面數據也(ye)能夠看(kan)到,被鐵線(xian)(xian)蟲糾纏的(de)(de)(de)女性(xing)(xing)遠遠多于男性(xing)(xing),所以希望(wang)廣大女性(xing)(xing)要(yao)重視起來。