鐵(tie)線蟲(chong)(Gordiacea Von Stebold,1843)又名發形(xing)蛇(hair snake),亦(yi)稱毛(mao)細線蟲(chong)(hairworm)或(huo)戈(ge)爾(er)迪烏斯線蟲(chong)(gordian worm),土(tu)名為銅絲蛇或(huo)天絲。
隸屬(shu)于(yu)線形動(dong)物門,為鐵線蟲(chong)(chong)(chong)(chong)綱蠕蟲(chong)(chong)(chong)(chong)的(de)總稱(cheng)。與(yu)醫學(xue)有關的(de)蟲(chong)(chong)(chong)(chong)種分屬(shu)于(yu)鐵線蟲(chong)(chong)(chong)(chong)目(Gordioidea)、鐵線蟲(chong)(chong)(chong)(chong)科(Gordiidae)、鐵線蟲(chong)(chong)(chong)(chong)屬(shu)(Gordius )和索蟲(chong)(chong)(chong)(chong)科的(de)Chordodes, Paragordius和Parachordodes屬(shu)等,250~300種。鐵線蟲(chong)(chong)(chong)(chong)體(ti)(ti)細長,馬鬃狀(zhuang),長可達1米。成蟲(chong)(chong)(chong)(chong)在(zai)海水(shui)或淡(dan)水(shui)中自由生活,幼蟲(chong)(chong)(chong)(chong)寄生在(zai)節肢動(dong)物體(ti)(ti)內。國內分布于(yu)南北方各省,國外(wai)廣泛分布于(yu)世界(jie)各地。可通過(guo)水(shui)源(yuan)感染人體(ti)(ti),引起鐵線蟲(chong)(chong)(chong)(chong)病。在(zai)科研中,常作為動(dong)物學(xue)的(de)實驗材(cai)料。
鐵線蟲見于(yu)熱帶(dai)和溫帶(dai),在(zai)水中(zhong)營(ying)自由生(sheng)活,偶能感染人體,寄生(sheng)于(yu)消化道(dao)內(nei)。成蟲呈(cheng)線狀,雌雄異體,雌蟲在(zai)水邊產卵,以蚱蜢、蟑(zhang)螂和甲蟲等(deng)昆蟲為中(zhong)間宿主。
大型(xing)個體(ti)(ti)(ti)(ti)(ti)(ti)。體(ti)(ti)(ti)(ti)(ti)(ti)長(chang)為(wei)300-1000毫(hao)米,體(ti)(ti)(ti)(ti)(ti)(ti)型(xing)似細繩狀。與(yu)線蟲的圓(yuan)蟲類相似,但無背線、腹線與(yu)側(ce)線。前端鈍圓(yuan),體(ti)(ti)(ti)(ti)(ti)(ti)表角質堅硬,雄體(ti)(ti)(ti)(ti)(ti)(ti)末端分(fen)叉,呈(cheng)倒 "V"字形,分(fen)叉部分(fen)的前腹面(mian)為(wei)泄殖孔。消(xiao)化管幼蟲期存在,而成(cheng)蟲期則退化。雄體(ti)(ti)(ti)(ti)(ti)(ti)的精巢和雌體(ti)(ti)(ti)(ti)(ti)(ti)的卵巢數目多,成(cheng)對排列于身體(ti)(ti)(ti)(ti)(ti)(ti)的兩側(ce)。生活時(shi)體(ti)(ti)(ti)(ti)(ti)(ti)呈(cheng)深棕色。
成蟲(chong)(chong)(chong)棲息于河流、池塘及水(shui)(shui)溝內,雌體(ti)所產的(de)(de)卵在水(shui)(shui)內孵出幼蟲(chong)(chong)(chong),被昆蟲(chong)(chong)(chong)或人類(lei)吃進后(hou),通過寄生生活(huo)。當這(zhe)種蟲(chong)(chong)(chong)被大(da)型節(jie)肢(zhi)(zhi)動(dong)物(wu)如螳螂、蝗蟲(chong)(chong)(chong)等吞食后(hou),幼蟲(chong)(chong)(chong)在這(zhe)些節(jie)肢(zhi)(zhi)動(dong)物(wu)體(ti)內繼續發育,會逐漸(jian)控制宿(su)(su)主的(de)(de)行為,幼蟲(chong)(chong)(chong)成長為成蟲(chong)(chong)(chong)時,會控制宿(su)(su)主尋找水(shui)(shui)源淹死(si)宿(su)(su)主后(hou)從宿(su)(su)主體(ti)內鉆出。
人類(lei)很容(rong)易(yi)在(zai)水(shui)(shui)池(chi)里(li)和(he)不干(gan)凈的(de)(de)水(shui)(shui)里(li)喝(he)到這些鐵線蟲(chong)的(de)(de)幼(you)蟲(chong),喝(he)下去(qu)后(hou)有(you)(you)一定幾率感染(ran)鐵線蟲(chong)病,這種病會使(shi)尿道感染(ran)發炎,所(suo)(suo)以池(chi)塘的(de)(de)水(shui)(shui)和(he)不干(gan)凈的(de)(de)水(shui)(shui)不能隨便喝(he)。幼(you)蟲(chong)在(zai)節肢動物體內會誘使(shi)寄生體去(qu)尋找水(shui)(shui)源,所(suo)(suo)以水(shui)(shui)源有(you)(you)節肢動物尸體的(de)(de)時(shi)候,不建議飲用。
成蟲(chong)在(zai)水中獨(du)自生活,偶爾感染(ran)人體,引(yin)起鐵線蟲(chong)病(nematomorphiasis)。本病女性多(duo)于男(nan)性。
蟲(chong)(chong)體(ti)(ti)細長,圓(yuan)線形(xing),似(si)鐵絲,黑褐色;長約10~50cm,寬約1~3mm; 頭端鈍圓(yuan),具(ju)有(you)0.5~1mm長的(de)淡(dan)黃色區(qu);蟲(chong)(chong)體(ti)(ti)表面(mian)有(you)許多小乳突;雄(xiong)蟲(chong)(chong)尾(wei)部(bu)卷曲,末端分(fen)叉;雌蟲(chong)(chong)尾(wei)短(duan)尖鈍。蟲(chong)(chong)體(ti)(ti)在體(ti)(ti)外(wai)非常活(huo)躍(yue),常有(you)自行打結的(de)習性。
鐵(tie)線(xian)蟲(chong)(chong)(chong)(chong)成蟲(chong)(chong)(chong)(chong)生活于沼澤、池塘(tang)、溪流、溝渠等水體(ti)(ti)中(zhong),雌雄交配(pei)產卵(luan),卵(luan)內(nei)幼蟲(chong)(chong)(chong)(chong)孵(fu)出進(jin)入昆(kun)蟲(chong)(chong)(chong)(chong)(蚱蜢(meng)(locust)、蟋蟀(Cricket)、蟑螂(Cockroach)、甲(jia)蟲(chong)(chong)(chong)(chong)(Beetle)等)體(ti)(ti)內(nei)發育(yu)(yu)形成稚(zhi)蟲(chong)(chong)(chong)(chong),昆(kun)蟲(chong)(chong)(chong)(chong)入水,稚(zhi)蟲(chong)(chong)(chong)(chong)離開宿(su)主在水中(zhong)發育(yu)(yu)為成蟲(chong)(chong)(chong)(chong)。人(ren)體(ti)(ti)消化道(dao)(dao)感(gan)染鐵(tie)線(xian)蟲(chong)(chong)(chong)(chong)可(ke)(ke)能是(shi)通過接(jie)觸或(huo)(huo)飲(yin)用含有(you)(you)稚(zhi)蟲(chong)(chong)(chong)(chong)的(de)(de)生水、昆(kun)蟲(chong)(chong)(chong)(chong)、魚(yu)類和螺類或(huo)(huo)食物而引起。尿(niao)(niao)路感(gan)染是(shi)由于人(ren)體(ti)(ti)會陰(yin)(yin)部(bu)接(jie)觸有(you)(you)鐵(tie)線(xian)蟲(chong)(chong)(chong)(chong)稚(zhi)蟲(chong)(chong)(chong)(chong)的(de)(de)水體(ti)(ti),經尿(niao)(niao)道(dao)(dao)侵入,上(shang)行至膀(bang)胱內(nei)寄(ji)生。蟲(chong)(chong)(chong)(chong)體(ti)(ti)侵入人(ren)體(ti)(ti)后可(ke)(ke)進(jin)一步發育(yu)(yu)至成蟲(chong)(chong)(chong)(chong),并可(ke)(ke)存(cun)活數(shu)年。寄(ji)生泌(mi)尿(niao)(niao)道(dao)(dao)的(de)(de)患(huan)者(zhe),以(yi)女性為多,均(jun)有(you)(you)明顯(xian)(xian)的(de)(de)泌(mi)尿(niao)(niao)道(dao)(dao)刺(ci)激癥(zheng),如下腹(fu)部(bu)劇烈疼痛(tong)、尿(niao)(niao)頻、尿(niao)(niao)急、尿(niao)(niao)痛(tong)、血尿(niao)(niao)、放射性腰痛(tong)、會陰(yin)(yin)和陰(yin)(yin)道(dao)(dao)炎(yan)等,蟲(chong)(chong)(chong)(chong)體(ti)(ti)排出后,癥(zheng)狀(zhuang)(zhuang)緩解(jie)。鐵(tie)線(xian)蟲(chong)(chong)(chong)(chong)寄(ji)生于消化道(dao)(dao)所引起的(de)(de)癥(zheng)狀(zhuang)(zhuang)一般不(bu)明顯(xian)(xian),可(ke)(ke)有(you)(you)消化不(bu)良、腹(fu)痛(tong)、腹(fu)瀉等表(biao)現。亦見有(you)(you)從眼(yan)眶(kuang)腫物或(huo)(huo)耳道(dao)(dao)檢(jian)出蟲(chong)(chong)(chong)(chong)體(ti)(ti)的(de)(de)報告。
診斷本病依據從尿中或糞便中檢(jian)獲蟲體。在臨(lin)床上若(ruo)遇到有(you)尿道(dao)刺激癥狀,久治不愈、而又有(you)生飲(yin)或會陰部(bu)接(jie)觸過塘、溝水(shui)或潮濕草地的患者,應考慮作(zuo)膀胱鏡檢(jian)。
鐵線(xian)蟲病(bing)盡(jin)管是(shi)一種較為罕見(jian)的(de)寄生(sheng)蟲病(bing),全世界只有(you)14個國家有(you)病(bing)例(li)(li)報道。但各地因生(sheng)產(chan)生(sheng)活(huo)接觸自然水體的(de)人(ren)群甚多,其實(shi)際感(gan)染人(ren)數可能遠比已報告的(de)例(li)(li)數要多。
防治(zhi)本病的關鍵是不(bu)飲不(bu)潔之水、不(bu)生吃昆蟲(chong)、魚類和螺類等食物,下水時避免(mian)下體與不(bu)潔水體直(zhi)接(jie)接(jie)觸(chu)。疑有感染者(zhe)可(ke)口服驅蟲(chong)藥促蟲(chong)排出,寄生于組織(zhi)內者(zhe)應手術取蟲(chong)。
遠(yuan)(yuan)離鐵線蟲(chong)疾病的(de)糾纏最(zui)好的(de)方(fang)法就是(shi)不(bu)要吃生的(de)食(shi)物,魚類,以及螺類食(shi)物,這些(xie)都是(shi)不(bu)太衛生的(de)食(shi)物。在飲食(shi)的(de)時候要注意看(kan)是(shi)否有與不(bu)干凈的(de)水體有關聯(lian)的(de)情況。而且,從臨床方(fang)面數據(ju)也能夠(gou)看(kan)到,被(bei)鐵線蟲(chong)糾纏的(de)女(nv)性(xing)遠(yuan)(yuan)遠(yuan)(yuan)多于男(nan)性(xing),所以希(xi)望(wang)廣(guang)大女(nv)性(xing)要重視起來。