Franchi C, Di Vico B, Teggi A
Department of Infectious and Tropical Diseases, University of Rome La Sapienza, Italy.
Clin Infect Dis. 1999 Aug;29(2):304-9. doi: 10.1086/520205.
Four hundred forty-eight patients with 929 Echinococcus granulosus hydatid cysts received 3- to 6-month continuous cycles of mebendazole or albendazole treatment and underwent prolonged follow-up by clinical visits and imaging studies (range, 1-14 years) to assess the long-term outcome of treatment. Degenerative changes and relapse were assessed by imaging techniques. At the end of therapy, 74.1% of the hydatid cysts showed degenerative changes. These were more frequent in albendazole-treated than in mebendazole-treated cysts (82.2% vs. 56.1%; P < .001). During long-term follow-up, 104 cysts (22%) had degenerative changes that progressed, whereas 163 cysts (approximately 25%) relapsed. The percentages of relapses in the two drug-treated groups were almost the same. Relapses occurred more frequently in type II cysts of the liver. Cysts recurred most often (78.5%; P < .001) within the first 2 years after treatment ended. Further chemotherapy cycles induced degenerative changes in >90% of relapsed cysts without inducing more frequent or more severe side effects than those observed during the initial cycles.
448例患有929个细粒棘球绦虫包虫囊肿的患者接受了3至6个月的甲苯咪唑或阿苯达唑连续治疗周期，并通过临床检查和影像学研究进行了长期随访（随访时间为1至14年），以评估治疗的长期效果。通过影像学技术评估退行性变化和复发情况。治疗结束时，74.1%的包虫囊肿出现退行性变化。这些变化在接受阿苯达唑治疗的囊肿中比接受甲苯咪唑治疗的囊肿中更常见（82.2%对56.1%；P<.001）。在长期随访期间，104个囊肿（22%）出现了进展性退行性变化，而163个囊肿（约25%）复发。两个药物治疗组的复发率几乎相同。复发在肝II型囊肿中更常见。囊肿在治疗结束后的头2年内复发最为频繁（78.5%；P<.001）。进一步的化疗周期使>90%的复发囊肿出现退行性变化，且未引发比初始周期更频繁或更严重的副作用。
