Davidson R N, Houston S, Kiire C F
Department of Medicine, University of Zimbabwe Medical School, Avondale, Harare.
Trans R Soc Trop Med Hyg. 1991 May-Jun;85(3):380-2. doi: 10.1016/0035-9203(91)90298-d.
Ultrasound (U/S) imaging of liver was used in a prospective study of 62 consecutive patients with oesophageal varices in the central hospitals in Harare; 50 had haematemesis. U/S changes of Symmers's periportal fibrosis (PPF) were graded from mild (grade 1) to gross (grade 4). 46 patients (74%) had U/S features of PPF: 7 were grade 1, 7 grade 2, 29 grade 3, and 3 grade 4. Patients with PPF were more likely to have bled (P less than 0.05) and were less likely to have ascites (P less than 0.05) than those without PPF. Spleen or liver size or grade of varices did not correlate with the U/S grade of PPF. Rectal snips were positive for schistosome ova in 19 of 28 cases with PPF and 2 of 7 cases without PPF. Patients with PPF were more likely than those without PPF (P less than 0.005) or controls (P less than 0.0001) to have spent their childhood in an area of Zimbabwe with a high prevalence of Schistosoma mansoni. Schistosomal PPF appears to be a common cause of portal hypertension in Zimbabwe. It is strongly associated with childhood spent in areas of high S. mansoni prevalence.
在哈拉雷中心医院对62例连续性食管静脉曲张患者进行的一项前瞻性研究中，采用了肝脏超声（U/S）成像；其中50例有呕血症状。Symmers门静脉周围纤维化（PPF）的超声变化从轻度（1级）到重度（4级）进行分级。46例患者（74%）有PPF的超声特征：7例为1级，7例为2级，29例为3级，3例为4级。与无PPF的患者相比，PPF患者更易出血（P<0.05），且腹水发生率更低（P<0.05）。脾脏或肝脏大小或静脉曲张分级与PPF的超声分级无关。在28例有PPF的病例中，19例直肠活检血吸虫卵呈阳性，7例无PPF的病例中有2例阳性。与无PPF的患者（P<0.005）或对照组（P<0.0001）相比，有PPF的患者更有可能在曼氏血吸虫病高发的津巴布韦地区度过童年。血吸虫性PPF似乎是津巴布韦门静脉高压的常见原因。它与在曼氏血吸虫病高发地区度过的童年密切相关。
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