西昌邛海周边地区超声检测日本血吸虫所致肝纤维化结果分析

目的了解日本血吸虫对西昌邛海周边地区人群肝脏损害的情况.方法随机选择该地区4个乡20个村民小组5～60岁村民1060例进行腹部超声检查.结果经超声检查肝纤维化异常率为26.89%,日本血吸虫感染率与肝纤维化异常率存在正相关(P<0.002), 虫卵负荷量与肝脏的损害有直接的关系(P<0.001);不同性别感染血吸虫者II级以上肝损害与未感染者差异有显著性(P<0.025);肝纤维化随年龄增长明显呈上升趋势;有血吸虫病诊断依据者肝纤维化异常率明显高于无依据者(P<0.005);未接受治疗的患者肝纤维化异常率与接受治疗者差异有显著性(P<0.025).结论人群肝纤维化与血吸虫病流行地区的感染率、感染度、接触疫水及治疗等因素有关,超声检测能直接评价人群血吸虫病病情.

Ultrasonographic Analysis on Liver Fibrosis in Schistos omiasis Endemic Qionghai Lake Area, Xichang City, Sichuan

Objective To investigate the situation of liver fibrosis and the relationship with schistosomiasis japonica. Method Liver parenchyma of 1 060 villagers aged 5~60 years in 20 villager growps of 4 townships, Xichang City was screened by ultrasonography according to WHO assessment guide. Besides, parasitological and serological examination were detected by Kato Katz quantitative method and ELISA. Results The total liver fibrosis rate was highly correlated with the schistosomiasis infection rate of the villagers ( P <0.002), while the liver damages were directly related to egg burden ( P <0.001). There were significant differences of liver fibrosis between infected and uninfected villagers ( P <0.005). The liver fibrosis became worse as the age grew up. The liver fibrosis rate was higher in villagers with parasitological or serological evidence of schistosomiasis than in those without evidence ( P <0.005). There were also significances of liver fibrosis rate between with and without schistosomiasis treatment history ( P <0.025). Conclusion The liver fibrosis rate closely related to the schistosomiasis infection rate, intensity of infection, exposure to the contaminated water and the treatment. Ultrasonography could well evaluate the morbidity induced by schistosomiasis japonica.