通讯作者: 李宏韬, 13979211776@163.com

DOI：10.12201/bmr.202608.00023

• 摘要：血吸虫病是全球重要的被忽视热带寄生虫病,约有2.5亿人感染,消化系统为其主要靶器官。虫卵沉积于肝脏和肠壁后诱发肉芽肿性炎症反应,进而导致肝纤维化、门静脉高压及结直肠肿瘤等严重后果。本文系统综述了血吸虫感染致消化系统损伤的病原学基础、病理生理机制、临床疾病谱、诊断策略及治疗进展。病理机制方面,虫卵可溶性抗原激活Th2型免疫应答,驱动M2巨噬细胞极化和肝星状细胞活化,通过TGF-beta/Smad、JAK2/STAT3等信号通路促进胶原沉积。临床表现为肝纤维化、食管胃底静脉曲张破裂出血、结直肠息肉及癌变等。诊断上,病原学检测仍为金标准,免疫学检测(CAA/CCA)和分子生物学技术(PCR、CRISPR-Cas13a)提高了灵敏度。吡喹酮是首选治疗药物,但面临再感染和耐药挑战；中医药在抗纤维化方面显示独特优势,疫苗研发仍在探索中。未来应着力于阐明纤维化关键分子节点、开发早期诊断标志物及优化综合防治策略。

  关键词： 血吸虫病; 消化系统; 肝纤维化; 门静脉高压; 结直肠肿瘤

   

  Abstract: Schistosomiasis is an important neglected tropical parasitic disease affecting approximately 250 million people worldwide, with the digestive system being its primary target organ. Following deposition of parasite eggs in the liver and intestinal wall, granulomatous inflammatory responses are triggered, leading to severe consequences including hepatic fibrosis, portal hypertension, and colorectal malignancy. This article systematically reviews the etiological basis, pathophysiological mechanisms, clinical spectrum, diagnostic strategies, and therapeutic advances of digestive system injury induced by schistosome infection. In terms of pathological mechanisms, soluble egg antigen activates type 2 immune responses, driving M2 macrophage polarization and hepatic stellate cell activation, thereby promoting collagen deposition through TGF-beta/Smad and JAK2/STAT3 signaling pathways. Clinical manifestations include hepatic fibrosis, esophagogastric variceal bleeding, colorectal polyps, and malignant transformation. Regarding diagnosis, parasitological detection remains the gold standard, while immunological assays (CAA/CCA) and molecular techniques (PCR, CRISPR-Cas13a) have improved sensitivity. Praziquantel is the first-line therapeutic agent, though challenges of reinfection and emerging resistance persist; traditional Chinese medicine shows unique advantages in anti-fibrotic therapy, and vaccine development remains an active area of investigation. Future efforts should focus on elucidating key molecular nodes in fibrogenesis, developing early diagnostic biomarkers, and optimizing integrated prevention and control strategies.

  Key words: schistosomiasis; digestive system; hepatic fibrosis; portal hypertension; colorectal neoplasms

  提交时间：2026-08-09

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-05-25	10.12201/bmr.202608.00023V1	下载

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