Medhat A, Nafeh M, Swifee Y, Helmy A, Zaki S, Shehata M, Ibrahim S, Abdel-Kader D A, Strickland G T
Department of Tropical Medicine, Assiut University Faculty of Medicine, Egypt.
Am J Trop Med Hyg. 1998 Jul;59(1):45-8. doi: 10.4269/ajtmh.1998.59.45.
Hepatic periportal thickening (HPT) detected by ultrasonography has been established as a reliable tool for measuring hepatic morbidity due to schistosomiasis. During ultrasonographic examination of patients with prolonged pyrexia, we frequently noticed minimal grades of HPT in patients without a history of schistosomiasis. This led to ultrasonographic studies of conditions other than schistosomiasis in which HPT may occur. Subjects included 460 patients with Schistosoma haematobium infection, 107 urban patients with prolonged pyrexia without previous exposure to schistosomiasis, and 288 healthy controls unexposed to schistosomiasis. Grade I HPT was more prevalent (P < 0.001) in patients with pyrexia (56.1%) than in those with S. haematobium (32.2%) and was more frequent (P < 0.001) in patients with S. haematobium than in controls (11.1%). Typhoid fever was the most common febrile illness causing HPT. Grade II lesions were rare in patients with pyrexia (2.8%) or schistosomiasis (0.9%). Grade III lesions were present in only one patient with S. haematobium. Mild grades of HPT can occur in infectious diseases other than schistosomiasis. Cellular infiltration in the portal tract from chronic infectious diseases can frequently give the ultrasonographic appearance of grade I HPT.
超声检查发现的肝门周围增厚（HPT）已被确立为衡量血吸虫病所致肝脏病变的可靠工具。在对长期发热患者进行超声检查时，我们经常在无血吸虫病史的患者中发现轻度HPT。这促使我们对可能出现HPT的血吸虫病以外的疾病进行超声研究。研究对象包括460例埃及血吸虫感染患者、107例既往无血吸虫接触史的长期发热城市患者以及288例未接触过血吸虫病的健康对照。I级HPT在发热患者中更为常见（P<0.001）（56.1%），高于埃及血吸虫患者（32.2%），且在埃及血吸虫患者中比在对照组中更频繁（P<0.001）（11.1%）。伤寒热是导致HPT最常见的发热性疾病。II级病变在发热患者（2.8%）或血吸虫病患者（0.9%）中罕见。III级病变仅在1例埃及血吸虫患者中出现。除血吸虫病外，其他传染病也可出现轻度HPT。慢性传染病导致的门管区细胞浸润常可产生I级HPT的超声表现。
