日本血吸虫病所致肝纤维化化疗后转归的观察  

OBSERVATION ON CHANGES OF LIVER FIBROSIS DUE TO SCHISTOSOMA JAPONICUM AFTER TREATMENT WITH PRAZIQUANTEL

作　　者：邱东川[1] 张桂盛[1] 文松[1] 张奕[1] 吴子松[1] 崔丽娜 山建忠 蔡兴平 李明树 

机构地区：[1]四川省寄生虫病防治研究所,成都610041 [2]四川省眉山县血吸虫病防治站

出　　处：《中国血吸虫病防治杂志》2000年第3期138-140,共3页Chinese Journal of Schistosomiasis Control

基　　金：UNDP/World Bank/WHO/TDR的资助

摘　　要：目的观察日本血吸虫所致肝纤维化患者经有效病原学治疗后，肝纤维化的转归。方法对３７９例经粪孵确诊的病例采用超声检测评价肝脏纤维化程度，从中随机抽取５０例作为对照组，３２９例作为实验组，实验组给予首次吡喹酮 ４０ｍｇ／ｋｇ顿服普治，并于每年６月及 １２月两次复查，阳性者１２月进行复治，连续治疗３年，对照组在首次及每年１２月均给予安慰剂治疗。超声检测于每年６月及１２月各检测１次。治疗及超声检测均采用双盲法。结果实验组Ⅰ级肝损害病例增加，治疗后第３０个月，出现了０级病例，Ⅲ级损害的比例出现逐年下降的趋势。对照组病情则呈现稳定不变或略有加重的趋势。两组病例肝纤维化转变的趋势经多元Ｌｏｇｉｓｔｉｃ回归分析，表明在控制时间因子的条件下，实验组下降趋势与对照组比较有显著性意义（ｔ＝４． ３８，Ｐ＜０． ０１）。结论日本血吸虫所致肝纤维化经过有效的病原治疗后，纤维化程度可得到明显的改善，３０个月后，轻度纤维化病例可恢复正常。Objective To observe the changes of liver fibrosis due to Schistosoma japonicum infection after treatment with praziquantel. Methods Three hundred and seventy-nine cases of schistosomiasis japonica confirmed with stool hatching test were investigated with ultrosonography to grade the liver damages. Among them, 50 cases were selected randomly as a control group, and the other 329 cases as the study group. Patients of study group were treated with praziquantel in a does of 40 mg/kg, one time each year, and were examined two times (June and December) a year with stool hatching test and serum circulating antigen detection. Those with positive result of one or two tests were retreated in each December for three years. Patients of control group were given placebo in each December for three years. Ultrasonography was performed in each June and December for three years. Both the treatment and ulrtasonography performing were in double blind method. Results The changes of liver fibrosis in both groups represented in different trend. In study group, the numbers of cases with the liver damage in grade m decreased year by year. Thirty months after treatment, some cases changed into grade 0 (normal image of ultrasonography). While in control group, the liver damages were almost the same or even a little bit worse. Multino mial Logistic Regression analysis indicated that the trend of changes of liver damage between two groups were significantly different, t=4. 38, P<0. 01. Conclusion The liver fibrosis due to Schis tosoma japonicum could recover to certain extent after effective treatment with praziquantel, and 30 months after treatment, some cases with mild liver damage could have a recovery.

关 键 词：日本血吸虫 肝纤维化 超声显像 转归 药物疗法 

分 类 号：R532.210.6[医药卫生—内科学] R575.2[医药卫生—临床医学]