瞬时弹性成像探测仪FibroScan在华支睾吸虫病中的临床应用

Clinical value of transient elastography(FibroScan) in detection of clonorchiasis

目的探索瞬时弹性成像探测仪Fibro Scan应用于华支睾吸虫病的临床意义,以期为患者驱虫治疗的疗效评估提供新思路。方法采用Fibro Scan检测华支睾吸虫病确诊患者驱虫治疗前后的肝脏硬度(LSM)值,并收集患者年龄、性别、体质指数(BMI)、食用鱼生持续时间、食用鱼生总量等指标,评价其与LSM的相关性。结果华支睾吸虫病确诊病例年龄、性别、BMI、食用鱼生持续时间、食用鱼生总量与治疗前LSM值间均无相关性(r/rs分别为0.189、0.073、0.180,0.071、–0.098、0.033,0.166、0.309、0.172,0.235、0.247、0.209,0.164、0.277、0.088;P均> 0.05)。同一患者驱虫治疗前第7、8、9肋间的LSM值差异有统计学意义(F=3.259,P <0.05),而驱虫治疗后差异则无统计学意义(F=0.851,P> 0.05),驱虫治疗后患者各肋间的LSM值均显著低于驱虫治疗前(t=6.724、5.603、2.884,P均<0.05)。结论 Fibro Scan可用于华支睾吸虫病患者驱虫治疗疗效评估,但在不同部位检测可影响LSM值。

Objective To assess the clinical significance of transient elastography(Fibroscan)in detection of clonorchiasis,so as to provide new insights into the assessment of therapeutic efficacy of deworming.Methods The liver stiffness measurement(LSM)values were measured in parasitologically diagnosed clonorchiasis patients using Fibro Scan before and after deworming,and the patients’age,gender,body mass index(BMI),duration of raw fish consumption and total amount of raw fish consumption were collected for correlation analyses.Results The clonorchiasis patients’age,gender,BMI,duration of raw fish consumption and total amount of raw fish consumption had no associations with pre-treatment LSM values(r/rs=0.189,0.073,0.180;0.071,–0.098,0.033;0.166,0.309,0.172;0.235,0.247,0.209;0.164,0.277,0.088;all P values>0.05).There was a significant difference in the LSM values from the seventh,eighth and ninth intercostal space prior to deworming(F=3.259,P<0.05),and no significant difference was detected after deworming(F=0.851,P>0.05).The LSM values from the seventh,eighth and ninth intercostal space were significantly lower pre-deworming than post-deworming(t=6.724,5.603,2.884;all P values<0.05).Conclusion Fibro Scan is feasible to assess the therapuetic efficacy of deworming in patients with clonorchiasis;however,measurement at various sites affects the LSM value.