慢性血吸虫病肝脏超声图象在临床检查中的应用

云南大山区血吸虫病呈高感染率、低感染度趋势,用B超对肝实质进行检查具有重要的意义,现将检查结果报告如下。1材料和方法1·1对象350例患者来源于洱源县人民医院B超室,受检者经县血防站、血吸虫病专科医院及上级血防部门粪便孵化或直肠镜检阳性并排除其它原因的肝病。1·2方法用日本ALokaSSD-210F及美国GE RTfinoV5型实时超声诊断仪,探头频率3·5MH,扫描比例1∶1,对患者进行检查,受检者空腹,平卧位。以剑下横、纵切面、右肋下斜面和右肋间切面为肝脏的常规切面。1·3B超图像判断标准光点型为肝实质图象光呈增多,增强,分布不均;光带…     

慢性乙型肝炎B型超声表现、病理分期、胆汁酸、前白蛋白、胆碱酯酶的相关研究

目的探讨 B 型超声(B 超)检查在慢性乙型肝炎诊断中的作用。方法对156例慢性乙型肝炎患者 B 型超声影像学表现、肝脏病理分期、胆汁酸(TBA)、前白蛋白(PAB)、胆碱酯酶(CHE)、门静脉宽度、脾厚度进行对比分析。结果 TBA、PAB、CHE、脾厚度、门静脉宽度等各项指标与肝纤维化(S1～S4)程度有关(P<0.05)。结论 B 型超声显像表现对判断慢性乙型肝炎病情有较大的价值。     

FibroScan检测与超声检查对肝纤维化程度诊断价值的对比分析

目的探讨FibroScan与超声检查诊断肝纤维化的异同性及关联性。方法以2012年10月-2014年2月就诊于本院的慢性HBV感染患者(305例)、慢性HCV感染患者(96例)及原发性胆汁性肝硬化(31例)为研究对象,记录患者肝脏弹性值(FS)及腹部B超的肝左叶厚、肝右叶厚、门静脉内径、脾厚、脾长、脾静脉内径、肝血管走形指标的检查结果,以及腹水、脂肪肝、胆囊疾病及肝硬化的发生率。采用Spearman相关性分析、多重线性回归分析进行FS与各项观察指标的相关性检验。不同FS值等级间各项指标的比较采用Kruskal-Wallis H检验或Mann-Whitney U检验。结果 FS值(r=0.249~0.543,P0.05)及FS值等级(r=0.229~0.541,P0.05)均与肝左叶厚径、脾脏长度和厚度、门静脉内径、脾静脉内径、肝表面光滑度、实质回声、血管走形清晰程度、腹水、肝硬化呈正相关;多重线性回归分析显示肝表面光滑度、肝左叶厚径、腹水、门静脉内径是FS值的独立影响因素(t值分别为5.123,3.703,3.113,2.985,P值均0.05);肝脏实质回声增强、增粗、结节状三组患者的FS值分别为(9.573±9.490)、(16.339±11.359)、(27.688±18.676)kPa,差异有统计学意义(χ2=98.469,P=0.000)。结论超声检查与FS值等级有较好的关联性,但FibroScan对肝纤维化的诊断更准确和客观。     

DWI肝脏ADC值和MRI测量肝脾大小比对肝纤维化及肝硬化早期诊断及分级的评估价值

目的探讨磁共振扩散加权成像(DWI)肝脏ADC值和MRI测量肝脾大小比对肝纤维化(HF)及肝硬化(LC)早期诊断及分级的评估价值分析。方法选取我院在2013年12月至2015年12月期间收治符合纳入标准的肝纤维化患者25例及肝硬化患者7例,其中肝纤维化患者使用国际慢性肝炎分级标准,将25例患者分为A组(n=13例)、B组(n=12例),A组为S1期~S2期;B组为S3期~S4期;收集正常肝脏人群18例作为对照组。其均应用我院MRI进行上腹部扫描;DWI测量肝脏ADC值;并应用T2 WI进行肝脾体积的计算。结果 MRI对4组患者进行上腹部扫描发现,与对照组相比,A组的肝体积(LV)增大,B组和肝硬化组的肝体积减少,且肝硬化组体积减少更多;肝硬化组的脾体积最小,且脾体积呈现对照组A组B组肝硬化组趋势;肝纤维化程度越高,肝脏的ADC值越小(F=307.500,P0.001),肝脾体积比值越小(F=346.700,P0.001)。结论肝脏ADC值和肝脾体积比值能更好反映肝脏病变情况,对肝纤维化及肝硬化早期诊断及分级的评估具有较好的效果。     

B超下对血吸虫病肝纤维化与肝炎后肝硬化门脉Ⅱ级分支外/内径比值的比较研究

80年代初,蔡卫民等曾用B超对50例晚期血吸虫病(血吸虫病肝纤维化)患者与正常人进行比较研究,发现血吸虫所致肝纤维化的肝实质呈“网格样”特征性改变。近年来,由于肝炎的流行,肝炎后肝硬化亦为常见。此两种肝病的鉴别对确定临床治疗方案及判断预后均十分重要。我们在开展超声     

剪切波弹性成像技术在不同谷丙转氨酶水平的乙型肝炎患者胆囊疾病及脾脏大小研究中的价值

目的 通过剪切波弹性成像(shear wave elastography,SWE)技术研究不同血清谷丙转氨酶(alanine transaminase,ALT)水平的乙型肝炎患者的肝弹性值与胆囊疾病及脾脏大小之间的关系。方法 选取2018年12月至2022年12月于深圳市第二人民医院就诊的肝弹性值升高的166例乙型肝炎患者,根据ALT水平将患者分为ALT测值正常组(N组)107例、测值升高但不超过正常值2倍组(Ha组)34例和测值升高且大于正常值2倍组(Hb组)25例,分析各组肝弹性值对胆囊疾病患病率和脾脏大小的影响,并分析肝弹性值与脾厚径的相关性。结果 (1)在N组、Ha组和Hb组中,性别构成比、胆囊疾病患病率与脾脏大小差异无统计学意义(P>0.05),年龄分布差异有统计学意义(P=0.010)。(2)N组胆囊疾病患者肝弹性值和年龄显著高于无胆囊疾病患者(P <0.001,P=0.005),校正年龄后,肝弹性值是胆囊疾病的危险因素(OR=1.167,P=0.040);N组脾大者肝弹性值显著高于无脾大者(P=0.006),肝弹性值是脾大的危险因素(OR=1.221,P=0....     

肝内结石病的影象学检查

20世纪70年代以来,随着超声技术与放射技术的进步,肝内结石病的诊断水平较前有了明显的提高。目前肝内结石病的影象学检查,主要包括:B型超声;CT和MRI;经皮肝穿刺胆道造影(PTC);逆行内镜胰胆管造影(ERCP)。而静脉胆道造影因其显影欠清晰,与其他技术相比有较大的不足,故现已少用。 1 B型超声检查 B型超声检查(简称B超)诊断胆道疾病是近年来的一项重大进展,该法简单,操作方便,结果可靠,可重复,费用低,患者易于接受,肝内胆管结石B超检查时大多数表现为强回声团伴后方声影,泥沙样结石则与肝实质回声水平相近,声影亦不明显。强回声团块在肝内既可呈散在分布,也可堆积成团,伴胆管囊样扩张,远端胆管扩张,更多时候表现为沿门静脉的     

肝组织免疫组化病人104例远期随访调查

目的　为了解病毒性肝炎患者肝组织不同免疫组化与远期预后关系。方法　采用回顾性前瞻性方法随访 6～ 8年前经肝穿病理组织学、免疫组化诊断的 132例肝病住院患者远期转归与肝组织免疫组化的关系。内容包括症状、体征、肝功能、HBVM、肝脾B超等指标。结果　随访到 10 4例中有 4例已死于肝硬化 ,病死率为 3 85 % ;存活 10 0例中 2例 (2 0 0 % )B超显示典型肝硬化改变 ,16例 (16 0 % )B超显示早期肝硬化改变 ,2 6例 (2 6 % )B超显示肝表面欠光滑 ,肝内实质呈弥漫性改变。肝组织HBsAg、HBcAg阳性者 ,ALT较易波动。结论　肝组织中HBsAg、HBcAg阳性者病情易波动 ,对预后影响不明显。     

92例晚期血吸虫病所致肺部损害X线表现

1　材料与方法1.1　一般资料　 92例均为血吸虫病疫区的晚期血吸虫病(晚血 )病人 ,男 77例 ,女 15例 ;年龄最小 36岁 ,最大 6 2岁 ,其中巨脾型 6 8例 (已切脾 5 3例 ) ,腹水型 2 4例。1.2　诊断标准　有反复的疫水接触史及肝、脾肿大 ,腹水等临床表现。血吸虫病原学检查或血清免疫学检查阳性者。“B”超提示肝实质有不同程度“鱼鳞”状改变。1.3　 X线检查　全部病例采用 KB- 5 0 0 m A放射线机进行透视或摄胸部正 ,侧位片观察肺部损害的情况。2　结果2 .1　肺间质改变　表现两中、下肺纹理模糊 ,且见斑点状阴影或网状结节增密影。2 .2　…     

血吸虫病流行区居民腹部超声显像指标典型相关及冗余度分析

目的　探讨日本血吸虫病肝、脾B超指标间以及与感染次数、感染时间和每克粪便平均虫卵数 (EPG )的相关性。　方法　采用典型相关方法分析肝、脾B超指标间及其与感染次数、感染时间和EPG的相关性 ,用冗余度分析方法分析肝、脾变异中有多少比例互为相关。　结果　男、女无既往感染组和既往感染组的第 1典型相关系数分别为0.7842、0.5483和 0.5800、0. 4220 (P值均 <0.01) ;男、女粪检阴性组和阳性组的第 1典型相关系数分别为 0.6063、0.5215和 0.6595、0.3849(P值均 <0. 01) ;男、女无既往感染组肝B超指标变异分别有 43.5 %和 17.5 %与脾B超指标变异有关 ,而既往感染组分别为 22.1%和 11.4%。而在男、女粪检阴性组分别为 26.8%和 16.8% ,粪检阳性组分别为 2 7.6%和 10.7% ;既往感染组 ,感染次数、调查时距首次感染时间和粪检阳性者的EPG与肝、脾B超指标的典型变量均无相关性 (P >0.05 )。　结论　日本血吸虫病肝、脾B超指标间具有典型相关关系 ,且男性的相关性大于女性 ;在既往感染者中感染次数、调查时距首次感染时间和粪检阳性者EPG与肝、脾B超指标的典型变量间均未发现相关性。     

超声测量静脉内径在血吸虫肝硬化及乙型肝炎肝硬化鉴别中的应用

目的探讨超声测量门静脉、脾静脉和肠膜上静脉内径在血吸虫肝硬化及乙肝肝硬化鉴别中的应用价值。方法选取2019年8月至2021年8月收治的78例肝硬化患者纳入研究对象,其中血吸虫肝硬化33例,乙肝肝硬化45例,另外选取同期于我院体检且身体健康的39名志愿者纳入研究对象。血吸虫肝硬化、乙肝肝硬化患者(治疗前)及健康人入院后均使用西门子Acuson Sequoia 512彩色多普勒超声诊断仪对门静脉主干内径(DPV)、脾静脉内径(DSPV)、肠系膜上静脉内径(DSMV)进行测量。对比血吸虫肝硬化、乙肝肝硬化患者及健康人DPV、DSPV及DSMV水平差异,借助ROC分析DPV诊断血吸虫肝硬化及乙肝肝硬化的价值。结果健康人DPV、DSPV及DSMV水平分别为(10.4±1.8)mm、(7.1±1.1)mm、(6.9±2.4)mm,血吸虫肝硬化患者DPV、DSPV及DSMV水平分别为(11.9±2.6)mm、(9.3±2.2)mm、(10.7±2.0)mm,乙肝肝硬化患者DPV、DSPV及DSMV水平分别为(14.8±3.3)mm、(9.4±2.4)mm、(10.8±2.3)mm;血吸虫肝硬化及乙肝肝硬化患者DPV、DSPV及DSMV水平显著高于健康人,差异有统计学意义(P<0.05);血吸虫肝硬化患者DPV水平显著低于乙肝肝硬化患者,差异有统计学意义(P<0.05)。经ROC分析证实DPV诊断血吸虫肝硬化的曲线下面积为0.734,标准误为0.056,95%CI为0.624~0.845,最佳截断值为10.750,敏感度为0.822,特异度为0.590,P<0.05;经ROC分析证实DPV诊断乙肝肝硬化的曲线下面积为0.825,标准误为0.053,95%CI为0.722~0.928,最佳截断值为12.300,敏感度为0.727,特异度为0.923,P<0.05。结论相对于健康人,血吸虫肝硬化及乙肝肝硬化患者DPV、DSPV及DSMV呈现出明显的增高,且血吸虫肝硬化及乙肝肝硬化患者DPV也存在明显的差异,经ROC分析证实DPV最佳截断值为10.750 mm、12.300 mm时能够为两种疾病的诊断、鉴别提供帮助。     

日本血吸虫病肝脏超声显像分析

目的提出日本血吸虫病肝脏超声显像肝实质图像的分类。方法利用原研究课题曾在洞庭湖的华容、汉寿、澧县中度流行区3个临湖自然村的居民及同期在本院住院的晚期血吸虫病人超声显像检查图像中的2918例肝脏图片,进行分类分型。结果肝实质图像有光点正常91例、增粗1757例、光斑121例、光条467例、光带482例等5类。其形状有光点正常91例、增粗1757例、光片59例、光斑62例、细条323例、粗条144例、细带280例、粗带202例等8型。结论超声显像诊断日本血吸虫病图像可分为5类8型。     

Laparoscopic left lateral hepatic lobectomy: a safer and faster technique

Background/Purpose

Laparoscopy for liver resection is highly specialized field because laparoscopic liver surgery presents severe technical difficulties, such as control of bleeding and risk of gas embolism. At present, a limited number of laparoscopic anatomical left lobectomies have been reported in the literature, but we believe that the use of stapling devices has made this technique safer and faster.

Methods

From January 2000 to May 2005, eight patients (five men, three women; mean age, 60.5 years) underwent laparoscopic anatomical left lobectomy at our department. Seven patients presented with hepatocellular carcinoma and cirrhosis, while one patient had a large symptomatic angioma. The average size of the lesions was 4.18?cm (range, 3.6–7.1?cm); all the lesions were localized in the anatomical left lobe (segments II–III). Transection of the liver parenchyma, together with sectioning of the vascular pedicle for segment II and III and of the left hepatic vein, was obtained by the use of stapling devices.

Results

The mean operative time was 142?min (range, 120–180?min). There were no intraoperative or postoperative complications, and blood transfusions were not required. The mean postoperative hospital stay was 5.75 days.

Conclusions

The key points of the technique are: late mobilization of the liver; no transection of the round ligament; no surrounding or taping of the portal pedicles or of the left hepatic vein; and the use of three consecutive linear staplers, turned to the left for transecting the liver parenchyma and vascular pedicle together. This technique, in our opinion, should be considered a new good option for patients with isolated lesions of the left lateral segments, but it must be performed by surgeons trained in both liver and advanced laparoscopic surgery.     

硫化氢对肝硬化大鼠肝脏survivin表达的影响

目的:探讨抗凋亡因子存活素(survivin)在硫化氢(hydrogen sulfide,H2S)干扰的肝硬化大鼠肝脏中的表达量,了解H2S在肝硬化过程中可能的作用机制.方法:♀SD大鼠经复合因素法复制肝硬化模型,造模结束后随机分为S组、P组、C组,分别腹腔注射硫氢化钠(sodium hydrogen sulfide,NaSH)56mg/(kgd)、炔丙基甘氨酸(Propargylglycine,PPG)30mg/(kgd)及等量生理盐水,用敏感硫电极法检测肝硬化大鼠门静脉中H2S的量,用免疫组织化学及realtime-PCR检测大鼠肝脏survivin蛋白及mRNA表达.结果:S组、P组与C组相比,门静脉血浆内H2S浓度显著改变(51.19mol/L±8.75mol/L,68.97mol/L±2.69mol/Lvs134.49mol/L±12.25mol/L,P<0.05),肝硬化H2S增加组大鼠survivin蛋白及mRNA表达显著增加(P<0.05),肝硬化大鼠体内H2S与survivin表达有相关性.结论:在大鼠肝硬化模型中,随着体内H2S浓度的变化,survivin蛋白及mRNA表达发生变化,这可能是H2S调节肝硬化作用过程中的机制之一.     

Study on histopathology,ultrasonography and some special serum enzymes and collagens for 38 advanced patients of schistosomiasis japonica

Thirty-eight cases clinically diagnosed as advanced schistosomiaisis were subject to splenectomy in Dongzhi County Special Hospital for Schistosomiasis because of portal hypertension, splenomegaly and/or hypersplenism. Liver biopsy was undertaken in all cases during surgical intervention. Before operation, ultrasonography on the liver and spleen was carried out. Also done was biochemical assay on several indices related to liver damage and fibrosis. Among the 38 cases, 24 were diagnosed as schistosomiasis by the finding of eggs in feces, 13 were diagnosed by positive serological test with IHA or COPT, and only in one case, the diagnosis of schistosomiasis was doubtful before operation. However, the eggs were found in the liver section upon histological examination. All the 38 cases had symptoms and signs of portal hypertension and most of them had general symptoms. Histories of hematemesis and melena were recorded in three cases. The causes of hospitalization were mainly splenomegaly and abdominal distension, and two were suffering from upper gastrointestinal bleeding. Upon histopathological examination, schistosome eggs were found in 33 out of 38 cases. Advanced schistosomaiasis was shown in 18 cases and schistosomiasis associated with hepatitis or cirrhosis was seen in other 20 patients. The main pathological changes were egg granulomas with different degrees of fibrosis and some differences in the pathological changes between schistosomal liver fibrosis (SLF) and mixed liver cirrhosis (both schistosome and hepatitis in origin) were seen. Compared with normal ultrasonography, in all the 38 cases, the length of the left and right liver, and the spleen, and the thickness of the left liver, the width of portal trunk, were all out of normal ranges. The differences between the patients and normal records were significant. However, there were no statistically significant differences in terms of above-mentioned indices as well as liver parenchyma changes on ultrasound between advanced schistosomaiasis and schistosomiasis complicated with hepatitis or cirrhosis (all P>0.5). According to WHO classification criteria on ultrasonography for schistosomiasis, among 20 cases combined with hepatitis or cirrhosis, 11 cases fell in Grade II, and nine cases in Grade III hepatic fibrosis, whereas among 18 cases with schistosomiasis fibrosis, 12 and six were in Grade II and III, respectively. The mean value of serum MAO, PIIIP, IVC and HA in the 38 cases were all significantly higher than normal range. However, no significant differences (all P>0.1) were seen between advanced schistosomiasis and those complicated with hepatitis or cirrhosis in terms of the levels of the four indices. The results showed that ultrasonography has its importance in the diagnosis and evaluation of liver fibrosis. However, in differentiation of the two types of liver damage, ultrasound does not provide important information. Histopathological examination, on the other hand, can provide useful information to identify the hepatic diseases.     

Theophylline metabolism in patients with hepatosplenic mansoniasis and cirrhosis.

The pharmacokinetics of theophylline were studied in 12 patients with hepatosplenic mansoniasis, 14 patients with cirrhosis and 16 normal controls. Following a single intravenous dose of aminophylline volumes of distribution, serum half-lives and body clearances were determined. Volumes of distribution of theophylline in patients with schistosomiasis (mean 0.624 l/kg) did not differ from cirrhotic patients (mean 0.616 l/kg) or normal controls (mean 0.593 l/kg). Cirrhotic patients had a prolonged half-life compared to normal subjects (mean 22.1 vs. 9.9 h), while patients with schistosomiasis did not substantially differ from normal controls (15.8 vs. 9.9 h). Body clearance in patients with schistosomiasis was similar to controls (34.02 vs. 49.20 ml/h per kg) but decreased (29.24 ml/h per kg) in patients with cirrhosis. Individual analysis of the group with schistosomiasis disclosed three patients with reduced theophylline elimination. No relationship was found between laboratory tests of liver function and the pharmacokinetics of theophylline in any group. The administration of theophylline to patients with hepatosplenic schistosomiasis, although less dangerous than in cirrhosis, must be closely followed.     

晚期血吸虫病肝硬化螺旋CT影像特征

分析262例晚期血吸虫病(晚血)肝硬化患者腹部CT表现。结果均有不同程度的肝硬化肝内钙化、肝内汇管区低密度灶及中心血管影、门静脉系统血管壁钙化、肠壁钙化等表现。特征性CT改变可为临床鉴别诊断提供依据。     

Hepato-systemic gradient of carbon monoxide in cirrhosis

Background and aims

Experimental data suggest that in liver cirrhosis splanchnic and systemic vasculature exhibit marked endothelial Carbon monoxide (CO) overproduction, while recent data demonstrated heme oxygenase (HO) hyperactivity in the liver of rats with cirrhosis. No data are so far available on CO levels in the hepatic veins of cirrhotic patients. We aimed at evaluating whether plasma CO levels differ between systemic (peripheral vein) and hepatic (hepatic vein) circulation in patients with viral cirrhosis with and without ascites.

Methods

We enrolled 31 consecutive non-smoking in- or outpatients with liver cirrhosis. We measured wedge (occluded, WHVP) and free hepatic venous pressures (FHVP) and hepatic-vein pressure gradient (HVPG) was the calculated. Plasma level of NO and plasma CO concentration were determined both in peripheral vein and in the hepatic vein in cirrhotics.

Results

In cirrhotic patients plasma CO levels were significantly higher in the hepatic vein (16.66 ± 10.71 p.p.m.) than in the peripheral vein (11.71 ± 7.00 p.p.m). Plasma NO levels were significantly higher in peripheral vein (97.02 ± 21.11 μmol/ml) than in the hepatic vein (60.76 ± 22.93 μmol/ml).

Conclusions

In patients with liver cirrhosis we documented a hepato-systemic CO gradient as inferred by the higher CO values in the hepatic vein than in the peripheral vein. In cirrhotic patients, CO and NO exhibit opposite behavior in the liver, while both molecules show increased values in the systemic circulation. It can be speculated that increased intra-hepatic CO levels might represent a counterbalancing response to reduced NO intra-hepatic levels in human liver cirrhosis.     

Effects of Dobutamine on Hepatosplanchnic Hemodynamics in Patients with Chronic Liver Disease

Kawasaki T, Moriyasu F, Kimura T, Someda H, Hamato N, Okuma M. Effects of dobutamine on hepatosplanchnic hemodynamics in patients with chronic liver disease. Scand J Gastroenterol 1994; 29:1044-1054.

Background: It is said that catecholamines increase hepatic blood flow in patients without liver diseases, although several reports have suggested a blunted response to catecholamines in patients with liver cirrhosis.

Methods: We investigated changes in splanchnic blood flow distribution induced by the infusion of dobutamine into peripheral veins of healthy adults (NC group), patients with chronic hepatitis (CH group), and patients with liver cirrhosis (LC group), using a Doppler duplex system (protocol 1). We also investigated changes in hepatic hemodynamics induced by dobutamine infusion in patients with liver cirrhosis (cirrhosis group) and patients without liver diseases (control group), using hepatic catheterization (protocol 2).

Results: In protocol 1 the average increase in portal venous blood flow during dobutamine infusion was significant in the NC and CH groups but was not significant in the LC group. Changes in the blood flow in the splenic artery and vein, superior mesenteric artery and vein, and femoral artery were similar to those in the portal vein in each of the three groups. Infusion did not cause a change in the common hepatic arterial flow in any of the three groups. In protocol 2 the portal venous flow, cardiac index, and hepatic venous pressure gradient increased significantly during dobutamine infusion in both the cirrhosis and the control groups. Hepatic vascular resistance in the cirrhosis group increased slightly, whereas, in contrast, that in the control group increased significantly. The rate of change in almost all variables was lower in the cirrhosis group than in the control group.

Conclusion: These results indicate that dobutamine has less effect on hepatic circulation in patients with liver cirrhosis than in those without liver diseases, indicating that the value of dobutamine in increasing hepatic blood flow in cirrhotic patients is very limited.     

当归补血汤治疗家兔血吸虫病肝纤维化的组织病理学分析

目的 探讨当归补血汤对家兔血吸虫病肝纤维化的治疗作用.方法 家兔34只,体质量2.0～2.5kg.取感染日本血吸虫的钉螺,置于150 ml三角烧瓶内逸蚴,每只家兔经腹部皮肤感染血吸虫尾蚴100条.感染血吸虫后第13周开始,每周B超检查家兔肝脏.在感染18周后,当B超确定家兔肝发生了纤维化,将家兔按体质量随机分为治疗组和对照组,对照组12只,治疗组按口服当归补血汤剂量分为高剂量组(50g/kg)和低剂量组(5 g/kg),每组11只.治疗组每天给药1次,连续给药10周,对照组不予治疗.在治疗开始时,3组家兔同时给吡喹酮进行杀虫治疗,吡喹酮剂量按300mg/kg,1次灌服.10周后解剖家兔,取出肝脏,HE染色,光镜下进行病理学观察,肝纤维化病理学分级采用Scheuer法.结果 家兔感染18周后,B超检查显示,肝实质粗网络状,高回声光带光斑,"地图样"改变,肝脏形态异常,门、脾静脉内径增宽,表明肝硬化动物模型复制成功.光镜下,高剂量组家兔肝脏有纤维化表现或轻度纤维化,肝脏汇管区扩大,周围少量纤维组织增生;低剂量组家兔肝脏轻微或中度纤维化,肝脏汇管区周围纤维组织增生明显,小叶结构保留;对照组家兔肝脏出现严重纤维化,肝脏汇管区周围大量的纤维组织增生,可见虫卵结节的分布.肝纤维化病理学分级组间比较差异有统计学意义(χ2=13.585,P<0.01);高剂量和低剂量组与对照组比较,差异有统计学意义(P均<0.01).结论 高剂量与低剂量当归补血汤对血吸虫病肝纤维化均有很好的治疗效果,对终止和逆转肝纤维化有一定的作用.