Cota Gláucia Fernandes, Pinto-Silva Rogério Augusto, Antunes Carlos Maurício Figueiredo, Lambertucci José Roberto
Serviço de Doenças Infecto-Parasitárias, Hospital das Clínicas, Departamento de Clínica Médica, Faculdade de Medicina, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Am J Trop Med Hyg. 2006 Jan;74(1):103-7.
The course of hepatosplenic schistosomiasis after mass chemotherapy with oxamniquine has been rarely reported. We report the effect of treatment in patients with advanced schistosomiasis mansoni living in area of Brazil highly endemic for this disease. A total of 739 inhabitants of a village were subjected to clinical and abdominal ultrasound examinations and were treated with oxamniquine. We have identified 84 individuals with hepatosplenic schistosomiasis. Alcohol abuse was associated with periportal thickening. Four years after treatment, 42 of the 84 individuals were re-examined and regression of splenomegaly was observed in 59% and of periportal thickening in 32%. Our data indicate that mass chemotherapy can lead to reduction of schistosomiasis morbidity but a significant group of patients (68%) will not improve. The association with alcohol abuse should be further evaluated. Thickening of the gallbladder wall can be a useful predictor of no involution of liver fibrosis after treatment.
使用奥沙尼喹进行大规模化疗后肝脾型血吸虫病的病程鲜有报道。我们报告了在巴西该病高度流行地区对晚期曼氏血吸虫病患者的治疗效果。对一个村庄的739名居民进行了临床和腹部超声检查，并用奥沙尼喹进行治疗。我们确定了84例肝脾型血吸虫病患者。酗酒与门静脉周围增厚有关。治疗四年后，对84例患者中的42例进行了复查，观察到脾肿大消退率为59%，门静脉周围增厚消退率为32%。我们的数据表明，大规模化疗可降低血吸虫病发病率，但相当一部分患者（68%）病情不会改善。酗酒之间的关联应进一步评估。胆囊壁增厚可能是治疗后肝纤维化未消退的有用预测指标。
