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[通过异种接种法对慢性克氏锥虫感染患者的寄生虫血症进行的纵向研究]

[Longitudinal study, by xenodiagnosis, of parasitemia in patients with chronic Trypanosoma cruzi infection].

作者信息

Schenone H, Rojas A

机构信息

Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

出版信息

Bol Chil Parasitol. 1999 Jan-Jun;54(1-2):29-32.

Abstract

A 2-5 years follow-up of parasitemia, by the use of xenodiagnosis (XD) was carried out in nine patients with chronic T. cruzi infection who proceeded from chagasic endemic areas of Chile. The patients (mean age 55 years) were hospitalized in the chronic section of a psychiatry institution sited in a permanent triatomines free urban area. Clinical examination, X-rays images (cardiovascular, esophagus and colon) and electrocardiogram resulted normal in all the patients. Basic study unit of parasitemia was a XD box which contained 7 nymphs III of Triatoma infestans which was used in a serial XD consisting in the simultaneous application of a pair of boxes a day during three consecutive days, making a total of six boxes (42 nymphs). The minimal time of duration of infection (M.D.I.) for each patient was estimated that this was adquired close to hospitalization. The M.D.I. varied between 6 and 45 years. The global positivity of XD boxes ranged between 6.3 and 84.7%, being in three patients lower than 12% and in six patients higher than 52%. In considering the yield of XD it is important to stress that during all the study of the nine patients with chronic chagasic infection 1282 XD boxes were applied resulting positive 582 (45.4%). At the end of the follow-up all patients received specific treatment for chagasic infection with nifurtimox at the daily dose of 10 mg/kg of body weight during 60 days. According to the result, two main conclusions arise: 1.--Serial XD has a high efficiency for detecting, evaluate and evolve parasitemia in patients with chronic chagasic infection. 2.--Parasitemia may present low, medium or high levels in different individuals and has a variable and fluctuating character.

摘要

对来自智利恰加斯病流行地区的9例慢性克氏锥虫感染患者,采用异种接种诊断法(XD)进行了2至5年的寄生虫血症随访。这些患者(平均年龄55岁)在位于一个永久性无锥蝽城市地区的精神病院慢性病区住院。所有患者的临床检查、X线影像(心血管、食管和结肠)及心电图均正常。寄生虫血症的基本研究单位是一个XD盒,其中装有7只III期大锥蝽若虫,用于连续XD,即每天同时使用一对盒子,连续进行三天,共使用六个盒子(42只若虫)。估计每位患者的最短感染持续时间(M.D.I.)是在接近住院时获得的。M.D.I.在6至45年之间。XD盒的总体阳性率在6.3%至84.7%之间,3例患者低于12%,6例患者高于52%。在考虑XD的检出率时,必须强调的是,在对9例慢性恰加斯病感染患者的整个研究过程中,共应用了1282个XD盒,其中582个呈阳性(45.4%)。随访结束时,所有患者均接受了针对恰加斯病感染的特效治疗,使用硝呋莫司,每日剂量为10mg/kg体重,持续60天。根据结果,得出两个主要结论:1. 连续XD在检测、评估和监测慢性恰加斯病感染患者的寄生虫血症方面具有很高的效率。2. 不同个体的寄生虫血症可能呈现低、中或高水平,且具有可变和波动的特征。

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