Hepatic Ultrasonography Evolution Infected By Schistosoma Japonicum And TGF-β1Expression

Objective:To investigate evolution of hepatic parenchyma and hepatic morphologyusing ultrasonograghy infected by Schistosoma japonicum.And to study theexpression level of transforming growth factor beta1(TGF-β1), along with evolutingof hepatic parenchyma.Methods:This study included36patients diagnosed with Schistosoma japonicum byliver biopsy or intestinal tissue biopsy,and selected14healthy controls randomly.Liverbiopsy was guided by abdominal ultrasonography,and intestinal tissue biopsy wasused by electronic colonoscope. Using color Doppler ultrasonography,hepaticparenchma of infectors was classified as grade0(non-change period),grade1(hepaticlesion period), grade2(hepatic fibrosis stage) and grade3(cirrhosis stage).Thensuperior-inferior and anteroposterior diameter of left liver lobe and maximum obliquediameter of right hepatic lobe were measured respectively.Real-time fluorescentquantitative RT-PCR was used to measure TGF-β1expression of peripheral bloodnucleated cells.Results:(1)The ratios of superior-inferior diameter of left liver to maximum oblique diameterof right liver in patients infected by Schistosoma japonicum are significantly higherthan that in controls(0.603±0.021VS0.500±0.0165, P=0.01); For the ratios ofanteroposterior diameter of left liver to maximum oblique diameter of rightliver,there are the same tendency (0.448±0.232VS0.525±0.0164, P=0.02).(2)The evolution of hepatic parenchyma in infectors has four stages as follows:grade 0(non-change period),grade1(hepatic lesion period), grade2(hepatic fibrosis stage)and grade3(cirrhosis stage).The ratios of superior-inferior diameter of left liver tomaximum oblique diameter of right liver in different stages are as follows:grade0(0.553±0.037), grade1(0.555±0.035), grade2(0.624±0.040) and grade3(0.648±0.047),but the difference has no statistical significance (P=0.345).However,the ratios of anteroposterior diameter of left liver to maximum obliquediameter of right liver are as follows:grade0(0.467±0.031),grade1(0.471±0.034),grade2(0.530±0.028) and grade3(0.606±0.020),and the difference is highlystatistically significant (P=0.010).(3)The differences of expression levels in infectors with different ages or differentsex have no statistical significance(P=0.055,P=0.108). But for various diseasedurations, The expression levels of TGF-β1are statistical significance(P=0.023).(4)The expression of TGF-β1in patients infected by Schistosoma japonicum wassignificantly higher than that in controls (0.102.±0.006VS0.055.±0.005, P=0.000).Among infected groups, the expression of TGF-β1are as follows:grade0(0.070±0.006),grade1(0.144±0.018), grade2(0.098±0.002) and grade3(0.090±0.003),and the difference is highly statistically significant (P=0.000).Conclusion:(1)Changes of hepatic morphology in infectors are the enlargement of left liverlobe.Particularly,the enlargement of anteroposterior diameter of left liver isremarkable.(2)The evolution of hepatic parenchyma in infectors is from non-change period tohepatic lesion period,then to hepatic fibrosis stage,and to cirrhosis stage.(3)The expression levels have nothing to do with ages or genders,but that seemrelated to disease durations.(4)The expression levels of TGF-β1in infectors are upregulated at grade0,reached apeak at grade1, and then decreased.