【摘要】 目的 了解血吸虫既往感染者体内血糖和血脂水平的现状，评估血吸虫感染对人体血糖和血脂代谢的影响。方法 在江苏省南、中、北部地区分层整群抽样共计3 086例有血吸虫感染史者，进行问卷调查、肝脏超声检查及实验室检测空腹血糖（FBG）和血脂4项（TC、TG、LDL-C、HDL-C）。结果 受调查者中病原学确诊者2 997例（97.12%），末次抗虫治疗距今（42.92±4.62）年，有糖尿病史者9.69%，高脂血症者8.69%。B超示肝实质异常者51.66%，肝左叶增厚者45.06%，门静脉增宽者20.95%。FBG为（5.73±1.53）mmol/L，阳性者23.17%；分组观察均值和阳性率与性别和门静脉内径无关，苏南>苏中>苏北，非农民高于农民，肝实质及肝左叶异常者高于正常者。TC、LDL-C、HDL-C分别为（4.82±1.21）mmol/L、（2.64±0.73）mmol/L、（1.47±0.41）mmol/L，均值都在正常范围，阳性率依次为17.53%、22.50%、10.65%；分组观察TC均值和阳性率女性高于男性，苏南>苏北>苏中，非农民高于农民，肝实质及门静脉内径异常者较高；TG为（1.79±1.80）mmol/L，高于正常，阳性率33.73%；分组观察各组内阳性率无差异。结论 血吸虫既往感染对人体血糖及血脂代谢的总体影响并不明显；FBG、TC变化与肝脏病损程度有一定的关联性，TG则不明显，但其HDL-C均值较高，而低HDL-C血症患病率较低的现象值得注意，其机制有待于进一步研究。更多还原

【Abstract】 Objective To understand the current status of blood glucose and blood lipid in patients with previous schistosome infection, and evaluate the effects of schistosoma infection on blood glucose and blood lipid metabolism. Methods Stratified Cluster Sampling was used in southern, central and northern part of Jiangsu Province. A total of 3 086 previously schistosome infeccted patients were enrolled in the study. Questionnaire, liver ultrasound examination, and laboratory tests including fasting blood glucose(FBG) and blood lipid(TC, TG, LDL-C and HDL-C) were conducted. Results Among all the participants, 2 997(97.12%) were confirmed by etiology, and it had been(42.92±4.62) years since the last anti-schistosome treatment. 9.69% of them had diabetes history, and 8.69% had hyperlipidemia. Ultrasonography showed 51.66% of them had abnormal liver parenchyma, 45.06% had thickened left lobe, and 20.95% had widened portal vein. FBG was(5.73±1.53)mmol/L, and 23.17% of participants showed an increase. There were no statistically significant differences among groups with different genders and portal vein diameters regarding to mean values and positive rate. These index were ranked from highest to lowest as South Jiangsu, Middle Jiangsu and North Jiangsu. In addition, mean values and positive rate showed higher level in non-farmers than those in farmers, and higher in abnormal liver parenchyma and left liver lobe than those in normal.The mean values of TC, LDL-C and HDL-C were(4.82±1.21)mmol/L,(2.64±0.73)mmol/L and(1.47±0.41)mmol/L,respectively, which were all in the normal range, with positive rates as 17.53%, 22.50% and 10.65%, respectively.The mean value and positive rate of TC were higher in female than those in male, and they were ranked as south Jiangsu>North Jiangsu>Middle Jiangsu. These index were higher in non-farmer than in farmer, and were higher in abnormal liver parenchyma and portal vein diameter group. The mean level of TG was(1.79±1.80)mmol/L, which was higher than normal level, with a positive rate of 33.73%. It showed no difference in positive rate among all groups.Conclusion The overall effects of previous schistosoma infection on blood glucose and blood lipid metabolism were not obvious. The changes of FBG and TC were related to liver damage to a certain extent, but TG did not show such relation. However, it is noteworthy that the mean value of HDL-C was higher while the prevalence of hypoHDL was lower. Further study is needed to clear its mechanism.更多还原