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目的观察鄱阳湖区血吸虫病疫区居民肝、脾超声图像特征及其转归,探讨超声显像(B超)在评估血吸虫病病情及其变化中的应用价值。方法1995年和2007年先后在江西省鄱阳湖区同一血吸虫病重疫区村对常住居民同时采用病原学方法和B超进行检查。结果1995年与2007年居民粪检阳性率分别为16.29%和8.54%,差异有统计学意义(P<0.01);居民肝、脾肿大率分别为8.82%和20.33%、8.54%和21.34%,差异均无统计学意义(P均>0.05);门静脉内径异常率分别为32.47%和6.50%,肝实质异常率分别为34.85%和51.83%,差异均有统计学意义(P均<0.01)。居民肝实质I级的发展具有双向性,2007年检查结果表明,1995年肝实质Ⅰ级者中有29.90%恢复正常,34.02%发展为Ⅱ级以上。B超各项指标的改变与居民职业、血吸虫感染与否有关。结论B超可用于诊断疫区居民血吸虫病病情和病理损伤,但其反映早期病变的敏感指标或评估病情状况的综合指标还有待进一步研究。
Objective To observe the characteristics of liver and spleen ultrasonography and its prognosis in schistosomiasis endemic areas in Poyang Lake, and to explore the value of ultrasound imaging (B-ultrasound) in assessing the status of schistosomiasis and its changes. Methods In 1995 and 2007, in the Poyang Lake area of Jiangxi Province, the same endemic area of schistosomiasis endemic to schistosomiasis residents using both etiological examination and B ultrasound. Results The positive rates of fecal examination among residents in 1995 and 2007 were 16.29% and 8.54%, respectively, with statistical significance (P <0.01). The rates of liver and spleen enlargement were 8.82%, 20.33%, 8.54% and 21.34% (P <0.05). The abnormal rates of portal vein anomalies were 32.47% and 6.50% respectively, and the abnormal rates of liver parenchyma were 34.85% and 51.83%, respectively (all P <0.01) . The development of residents with liver parenchyma level I has a two-way, in 2007 the test results showed that in 1995, liver parenchyma grade I were 29.90% returned to normal, 34.02% developed to Ⅱ level above. B-change in various indicators and residential occupational, schistosome infection or not. Conclusion B-ultrasound can be used to diagnose schistosomiasis condition and pathological injury in affected areas. However, it still needs to be further studied to reflect the sensitive index of early stage lesion or evaluate the comprehensive evaluation of disease status.