【摘要】 目的　对吡喹酮治疗日本血吸虫病患者 2 4 7例进行 2 4年后第 8次追踪调查 ,以观察病情动态变化和吡喹酮药物治疗的远期疗效。方法　对 2 4 7例患者进行病史询问、体格检查及实验室检查 :肝功能、肾功能、乙型肝炎病毒标志、丙型肝炎抗体、血吸虫免疫及肝纤维化指标 ,同时作B超检查。结果　 2 4 7例中脾脏较前增大者 4 3例 (17.4 1% ) ;丙型肝炎抗体均为阴性 ,而HBsAg、HBeAg、抗 HBc均为阳性 1例 ,HBsAg、抗 HBe、抗 HBc均为阳性 8例 ;血吸虫免疫测定中 ,环卵沉淀试验复查均为阴性 ,而间接血凝阳性 12例 (4.85 % ) ,酶联免疫吸咐试验阳性 38例 (15 .38% ) ,2项均为阳性 12例 (4.86 % ) ;对 16 2例患者进行肝纤维化指标测定 ,其中 12 1例 (74 .6 9% )出现不同程度的增高 ,而体力恢复尚可。但治后仍可见部分病例有脾肿大、肝纤维化指标不同程度增高 ,血吸虫免疫测定也有一定数量的阳性。结论　吡喹酮治疗日本血吸虫病远期观察安全有效 ,但血吸虫性肝病 ,虽经杀虫治疗后其肝纤维化仍可继续发展 ,抗肝纤维化的药物治疗很有必要。更多还原

【Abstract】 Objective To explore the long term efficacy of pyquiton on Schistosomiasis japonica. Methods 247 cases of Schistosomiasis japonica were investigated, including history, physical examination, and related laboratory tests, such as liver and kidney function, hepatitis B virus antigen and antibody, hepatitis C virus antibody, schistosome antibody and liver fibrosis index, and B mode ultrasonography as well. Results 43 cases (17.4%) had splenomegaly and all of the 247 cases were hepatitis C virus antibody negative. One case was HBsAg, HBeAg and HBcAb positive. Eight cases were HBsAg, HBeAb, HBcAb positive. COPT tests were negative in all cases. IHA test was positive in 12 cases(4.9%). ELISA test was positive in 38 cases(15.4%). Both IHA and ELISA were positive for in cases(4.9%). 162 cases accepted tests for liver fibrosis markers. 121 cases showed a higher level of liver fibrosis index, but their strength recovered. In the meantime, we found some cases had splenomegaly and liver fibrosis. And there are some positive results of schistosome immune tests. Conclusions These results suggested that schistosome liver disease may progress even after anti schistosome treatment and therefore it is necessary to use anti liver fibrosis therapy for patients with schistosome liver disease after anti schistosome treatment.更多还原