阿米巴病

对阿米巴病疑似患者，在开始治疗前进行此检查。

只有 CellLab 或 TechLab 的溶组织内阿米巴 II 试验可特异性地识别溶组织内阿米巴；其他抗原检测实验检测溶组织内阿米巴-迪斯帕内阿米巴-莫氏内阿米巴复合抗原。[15]Haque R, Mollah NU, Ali IKM, et al. Diagnosis of amebic liver abscess and intestinal infection with the TechLab Entamoeba histolytica II antigen detection and antibody tests. J Clin Microbiol. 2000;38:3235-3239.http://jcm.asm.org/cgi/content/full/38/9/3235?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=0&volume=38&firstpage=3235&resourcetype=HWCIT

寄生虫抗原呈阳性

实时定量 PCR (qPCR) 检测粪便样本比传统 PCR 更具敏感性。[16]Roy S, Kabir M, Mondal D, et al. Real-time PCR assay for the diagnosis of Entamoeba histolytica Infection. J Clin Microbiol. 2005;43:2168-2172.http://www.ncbi.nlm.nih.gov/pubmed/15872237?tool=bestpractice.com

肝脓肿脓液的 PCR 或 qPCR 对阿米巴肝脓肿的诊断具有确定作用。

尿液和唾液样本的实时 PCR 测定结果检测肝脓肿和肠道感染中的溶组织内阿米巴 DNA 的敏感性分别为 97% 和 89%。[17]Haque R, Kabir M, Noor Z, et al. Diagnosis of amebic liver abscess and amebic colitis by detection of Entamoeba histolytica DNA in blood, urine, and saliva by a real-time PCR assay. J Clin Microbiol. 2010;48:2798-2801.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2916621/http://www.ncbi.nlm.nih.gov/pubmed/20534800?tool=bestpractice.com

阿米巴 DNA 扩增

对阿米巴病疑似患者，在开始治疗前应进行此检查。[15]Haque R, Mollah NU, Ali IKM, et al. Diagnosis of amebic liver abscess and intestinal infection with the TechLab Entamoeba histolytica II antigen detection and antibody tests. J Clin Microbiol. 2000;38:3235-3239.http://jcm.asm.org/cgi/content/full/38/9/3235?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=0&volume=38&firstpage=3235&resourcetype=HWCIT

发病期的敏感性 (60%~70%) 比恢复期低。

患者在感染后数年内仍呈阳性。[15]Haque R, Mollah NU, Ali IKM, et al. Diagnosis of amebic liver abscess and intestinal infection with the TechLab Entamoeba histolytica II antigen detection and antibody tests. J Clin Microbiol. 2000;38:3235-3239.http://jcm.asm.org/cgi/content/full/38/9/3235?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=0&volume=38&firstpage=3235&resourcetype=HWCIT

抗阿米巴抗体呈阳性

尽管敏感性或特异性不如其他试验，但临床上仍用于确诊阿米巴肠道感染。[1]Haque R, Huston CD, Hughes M, et al. Amebiasis. New Engl J Med. 2003;348:1565-1573.http://www.ncbi.nlm.nih.gov/pubmed/12700377?tool=bestpractice.com[2]Petri WA Jr, Singh U. Diagnosis and management of amebiasis. Clin Infect Dis. 1999;29:1117-1125.http://www.ncbi.nlm.nih.gov/pubmed/10524950?tool=bestpractice.com[3]Solaymani-Mohammadi S, Lam M, Zunt JR. Entamoeba histolytica encephalitis diagnosed by polymerase chain reaction of cerebrospinal fluid. Trans R Soc Trop Med Hyg. 2007;101:311-313.http://www.ncbi.nlm.nih.gov/pubmed/16930651?tool=bestpractice.com[4]Snider C, Petri WA Jr. Travel Medicine. In: Rakel RE, ed. Conn's current therapy 2008. 61st ed. New York, NY: W.B. Saunders; 2007.[5]Stanley SL Jr. Amoebiasis. Lancet. 2003;361:1025-1034.http://www.ncbi.nlm.nih.gov/pubmed/12660071?tool=bestpractice.com

粪便中发现内阿米巴原虫

活检样本应从溃疡边缘采集。组织学检查可能显示滋养体。[2]Petri WA Jr, Singh U. Diagnosis and management of amebiasis. Clin Infect Dis. 1999;29:1117-1125.http://www.ncbi.nlm.nih.gov/pubmed/10524950?tool=bestpractice.com[Figure caption and citation for the preceding image starts]: 结肠内的阿米巴溃疡：大体病理显示结肠溃疡的直径平均为 1~2 mm。转自《新英格兰医学期刊》 (2003)；经获准使用 [Citation ends].

内镜检查可使结肠炎病灶中的阿米巴实时可视。[18]Hosoe N, Kobayashi T, Kanai T, et al. In vivo visualization of trophozoites in patients with amoebic colitis by using a newly developed endocytoscope. Gastrointest Endosc. 2010;72:643-646.http://www.ncbi.nlm.nih.gov/pubmed/20579647?tool=bestpractice.com

黏膜呈颗粒状、易碎且出现弥漫性溃疡

仅对阿米巴肝脏感染的患者有效，对阿米巴肠道感染无效。[1]Haque R, Huston CD, Hughes M, et al. Amebiasis. New Engl J Med. 2003;348:1565-1573.http://www.ncbi.nlm.nih.gov/pubmed/12700377?tool=bestpractice.com

无法与化脓性脓肿区分。[2]Petri WA Jr, Singh U. Diagnosis and management of amebiasis. Clin Infect Dis. 1999;29:1117-1125.http://www.ncbi.nlm.nih.gov/pubmed/10524950?tool=bestpractice.com

均质低回声圆形或椭圆形病变

如果临床表现提示积液和肝脓肿，进行此检查。[Figure caption and citation for the preceding image starts]: 阿米巴肝脓肿患者的后前位和侧位胸部 X 光片：胸部 X 光片结果包括右侧膈肌抬高和肺不张转自《新英格兰医学期刊》 (2003)；经获准使用 [Citation ends].

右侧膈肌抬高或右侧胸膜腔积液

无法与化脓性脓肿区分。[2]Petri WA Jr, Singh U. Diagnosis and management of amebiasis. Clin Infect Dis. 1999;29:1117-1125.http://www.ncbi.nlm.nih.gov/pubmed/10524950?tool=bestpractice.com[Figure caption and citation for the preceding image starts]: 溶组织内阿米巴脑脓肿转自《皇家热带医学和卫生学学会汇报》 (2007) ；经获准使用 [Citation ends].

圆形、界限清楚、低衰减病变；肠壁使用造影剂后增强；胸膜腔积液

如果出现神经学症状，需要进行此检查。

占位性病变