门脉主干壁厚检测对日本血吸虫病肝纤维化的临床意义

DETERMINATION OF THE THICKNESS OF THE WALL OF PORTAL VEIN TRUNK IN PATIENTSOF SCHISTOSOMIASIS JAPONICA WITH HEPATIC FIBROSIS AND ITS CLINICAL SIGNIFICANCE

对１１７例血吸虫病患者、３０例肝炎后肝硬化患者及３２例健康人分别用Ｂ超检测其门脉主干壁。结果表明，血吸虫病患者门脉主干壁普遍增厚；血吸虫病肝纤维化，急者较血吸虫病非肝纤维化、肝炎后肝硬化及健康人都有显著增厚；随着血吸虫病肝纤维化Ｉ、ＩＩ、ＩＩＩ期病情加重，其门脉主干壁厚亦递增。这改变不仅与血清透明质酸、羟脯氨酸等胶原代谢测值同步，而且与肝实质纤维变、门脉分支外径等国际ＴＤＲ血吸虫病超声指标检测结果高度正相关。

he thickness of the wa11 of the portal vein trunk(PVT) was determined with B-mode ultrasonoga-phy in 82 patients of schistosomiasis,with hepatic fibrosis,35 cases of schistosomiasis without hepatic fi-brosis,30 cases of posthepatitis cirrhosis and 32 healthy subjects.It was shown that the wall thickness ofPVT increased in all the patients with schistosomiasis.The thickness in patients of schistosomiasis withhepatic fibrosis was markedly increased as compared with the other three groups (P< 0. 01 in all).Themagnitude of increase of the wall thickness correlated well with the severity of the pathological change ofhepatic fibrosis. It was also noted that change of wall thickness of PVT was not only accompanied bychange in hyaluronate and hydroxyprolin estimation,but also closely correlated with the international crite-ria of ultrasound parameters for assessment of pathological changes of schistosomiasis(r_s=0. 839,r_s=0.74 8).Measuremen of the wall thickness of PVT is, therefore, a valuable clinical method for diagnosingschistosomiasis with hepatic fibrosis and determining the severity of its pathological change.