Ultrasonpgraphic liver images and evaluation of liver fibrosis in Schistosoma japonicum infections

我们在菲律宾莱特血吸虫病研究与控制医院的登记患者中进行了这项研究。肝纤维化通过超声（US）检查结果和血清标志物如前胶原-III-肽（P-III-P）和IV型胶原进行评估。通过每1克粪便中的虫卵数检测感染强度。在高强度的年轻患者中，我们发现了典型的网络模式。然而，在老年患者中，我们没有发现网络模式和感染强度之间的关系。在177例经粪便检查确诊的患者中，约70%的患者表现为P-III-P和/或IV型胶原升高。特别是在20岁以下的青年患者中，90%以上的血清标志物升高。在日本血吸虫病流行区的青年患者中，我们发现超声检测的肝纤维化进展与血清标志物和感染强度密切相关。根据这些结果，我们通过亚洲血吸虫病控制联合计划（亚洲血吸虫病区域网络）的活动，标准化了美国日本血吸虫病诊断标准。

We performed this research among the enrolled patients of Schistosomiasis Research & Control Hospital, Leyte, the Philippines. Liver fibrosis was evaluated by ultrasonographic(US) findings and serum markers such as procollagen-III-peptide(P-III-P) and type IV collagen. Intensity of the infection was detected by number of eggs per 1 gram of feces. Among young patients with high intensity, we found typical network pattern by US. Among elder patients, however, we found no relationship between network pattern and intensity of the infection. Out of 177 patients diagnosed by stool examination, about 70% patients showed elevation of P-III-P and/or Type IV collagen. Especially, more than 90% of young patients less than 20 years old showed elevation of these serum markers. In young patients from S.japonicum endemic area, we found close relationship between the progress of liver fibrosis detected by US and serum markers and intensity of the infection. Based on these results, we standardized criteria of US diagnosis on schistosomiasis japonica through activities of a joint program for control of Asian Schistosomiasis, Regional Network on Asian Schistosomiasis.