Clinical Application Of Fibroscan In Patients Of Clonorchiasis Sinensis

OBJECTIVE: This study is aimed to explore whether some factors would affect the liver stiffness measurement measured by Fibroscan and whether the liver stiffness measurement will change before and after chemotherapy.And we want to know those changes will be of clinical significance in judging the curative effect of patients with clonorchiasis sinensis or not.We hope this study will provide a guidance for clinician to analyse the results of Fibroscan and provide a new idea for evaluating the efficacy of repellent treatment in patients with clonorchiasis sinensis infection.METHODS: We recruited 53 patients prospectively from First Affiliated Hospital of Guangxi Medical University,among which 13 cases were lost and40 cases were finally obtained.All of them were the first time to receive insect repellent therapy.Those patients were diagnosed with liver fluke disease and had no risk factors of liver damage,viral hepatitis,alcoholic hepatitis,fatty liver,cholestasis,liver cirrhosis,liver neoplasms,for example.All patients underwent Fibroscan at 3 sites(the Seventh,Eighth and Ninth intercostal space)before taking insect repellent drugs.Age,sex,BMI,durations of ingested freshwater raw fish or shrimp and total amount of freshwater raw fish or shrimp were recorded at the same time.All patients would reexamine Fibroscan 12 weekslater after chemotherapy.LSM values obtained from three different sites in the same patient was compared with the analysis of variance before and after chemotherapy.The changes of LSM value before and after chemotherapy were compared,and the relationship between LSM value and the other factors recorded was analyzed,too.RESULTS:(1)On partial correlation analysis,age,gender,BMI,duration and amount showed no significant correlations with the Seventh,Eighth and Ninth intercostal space LSM values,the Seventh intercostal space r=0.003,P=0.986;r=0.107,P=0.536;r=0.184,P=0.284;r=0.187,P=0.275;r=0.024,P=0.888;the Eighth intercostal space r=-0.154,P=0.371;r=-0.011,P=0.951;r=0.293,P=0.083;r=0.267,P=0.115;r=0.064,P=0.710;the Ninth intercostal space r=0.039,P=0.821;r=0.056,P=0.745;r=0.095,P=0.580;r=0.142,P=0.409;r=0.015,P=0.931,respectively;(2)LSM values obtained from three different sites in the same patient was compared with the analysis of variance before and after chemotherapy,P=0.044,0.431,respectively;(3)A paired t-test showed that the LSM values undergone at 3 sites in the same patient after chemotherapy were significantly lower than that before chemotherapy,P=0.000,0.000,0.006,respectively.CONCLUSION:(1)Whether age,sex,body mass index(BMI),duration of fish consumption and total amount of food fish will affect the results of fibroscan should be further explored;(2)Clonorchiasis sinensis has effect on LSM value,but the detection site in patients with clonorchiasis sinensis has effect on LSM value before chemotherapy while has no effect on LSM value after chemotherapy;(3)Fibroscan examination is of clinical significance in the curative effect judgment of patients with clonorchiasis sinensis.