Souza M R, Toledo C F, Borges D R
Department of Medicine, Universidade Federal de São Paulo, Brazil.
Dig Dis Sci. 2000 Oct;45(10):1964-70. doi: 10.1023/a:1005535808464.
Sufferers of schistosomiasis mansoni can evolve a clinical form of the disease associated with portal hypertension. To differentiate this form, routine clinical tests and biological indices were evaluated. In all, 54 HBsAg- and HCV-negative patients were studied, 42 with schistosomiasis and 12 normal volunteers. Using clinical criteria, ultrasonography, and endoscopy, the schistosomiasis patients were classified into two groups: mild chronic form (MS, N = 14) and chronic form associated with portal hypertension (PH, N = 28). The laboratory parameters of the MS group did not differ from the controls. The PH group differed from the others in prothrombin index, thrombocytemia, gamma-glutamyltransferase, serum alpha2-macroglobulin, and the calculated indices. ROC plot cutoff levels verified that isolated thrombocytemia was the most efficient marker for discrimination of the PH and MS forms. Thrombocytemia of 130 x 10(9) platelets/liter discriminated the groups with an 86% accuracy when all patients were analyzed and 96% when only schistosomiasis patients who did not consume alcohol were included.
曼氏血吸虫病患者可能会发展出一种与门静脉高压相关的临床疾病形式。为了鉴别这种疾病形式，对常规临床检查和生物学指标进行了评估。总共研究了54名乙肝表面抗原和丙肝病毒阴性的患者，其中42名患有血吸虫病，12名是正常志愿者。利用临床标准、超声检查和内窥镜检查，将血吸虫病患者分为两组：轻度慢性形式（MS，n = 14）和与门静脉高压相关的慢性形式（PH，n = 28）。MS组的实验室参数与对照组无差异。PH组在凝血酶原指数、血小板减少、γ-谷氨酰转移酶、血清α2-巨球蛋白和计算得出的指标方面与其他组不同。ROC曲线截断水平证实，单纯血小板减少是区分PH和MS形式的最有效标志物。当分析所有患者时，血小板计数为130×10⁹/升可区分两组，准确率为86%；当仅纳入不饮酒的血吸虫病患者时，准确率为96%。
