Douglass Janet, Graves Patricia, Lindsay Daniel, Becker Luke, Roineau Maureen, Masson Jesse, Aye Ni Ni, Win San San, Wai Tint, Win Yi Yi, Gordon Susan
Division of Tropical Health and Medicine, James Cook University, Townsville 4811, Australia.
Division of Tropical Health and Medicine, James Cook University, Cairns 4870, Australia.
Trop Med Infect Dis. 2017 Sep 27;2(4):50. doi: 10.3390/tropicalmed2040050.
When normal lymphatic function is hampered, imperceptible subcutaneous edema can develop and progress to overt lymphedema. Low-cost reliable devices for objective assessment of lymphedema are well accepted in clinical practice and research on breast-cancer related lymphedema but are untested in populations with lymphatic filariasis (LF). This is a cross-sectional analysis of baseline data in a longitudinal study on asymptomatic, LF antigen-positive and -negative young people in Myanmar. Rapid field screening was used to identify antigen-positive cases and a group of antigen-negative controls of similar age and gender were invited to continue in the study. Tissue compressibility was assessed with three tissue tonometers, and free fluids were assessed using bio-impedance spectroscopy (BIS). Infection status was confirmed by Og4C3 antigen assay. At baseline ( = 98), antigen-positive cases had clinically relevant increases in tissue compressibility at the calf using a digital Indurometer (11.1%, = 0.021), and in whole-leg free fluid using BIS (9.2%, = 0.053). Regression analysis for moderating factors (age, gender, hydration) reinforced the between-infection group differences. Results demonstrate that sub-clinical changes associated with infection can be detected in asymptomatic cases. Further exploration of these low-cost devices in clinical and research settings on filariasis-related lymphedema are warranted.
当正常的淋巴功能受到阻碍时，难以察觉的皮下水肿会出现并发展为明显的淋巴水肿。用于客观评估淋巴水肿的低成本可靠设备在乳腺癌相关淋巴水肿的临床实践和研究中得到了广泛认可，但在淋巴丝虫病（LF）患者中尚未经过测试。这是一项对缅甸无症状、LF抗原阳性和阴性年轻人的纵向研究中的基线数据进行的横断面分析。采用快速现场筛查来识别抗原阳性病例，并邀请一组年龄和性别相似的抗原阴性对照者继续参与研究。使用三种组织张力计评估组织可压缩性，并使用生物电阻抗光谱法（BIS）评估游离液体。通过Og4C3抗原检测确认感染状态。在基线时（n = 98），抗原阳性病例使用数字硬度计测量小腿组织可压缩性有临床相关增加（11.1%，P = 0.021），使用BIS测量全腿游离液体有增加（9.2%，P = 0.053）。对调节因素（年龄、性别、水合作用）的回归分析强化了感染组之间的差异。结果表明，在无症状病例中可以检测到与感染相关的亚临床变化。有必要在丝虫病相关淋巴水肿的临床和研究环境中进一步探索这些低成本设备。
