Sowunmi A, Adedeji A A, Sowunmi C O, Falade A G, Sijuade A O, Oduola A M
Department of Pharmacology and Therapeutics, University of Ibadan, Nigeria.
Ann Trop Med Parasitol. 2000 Sep;94(6):549-58. doi: 10.1080/00034983.2000.11813577.
The clinical characteristics and the responses to oral antimalarial therapy of 104 children presenting consecutively with or without Plasmodium falciparum hyperparasitaemia (HP) were investigated in an endemic area. At presentation, although the 52 children with HP were significantly younger and had significantly higher heart rates than the 52 without, there were no significant differences between the two groups in their symptoms or in any other clinical feature of their malaria. Responses to oral antimalarial drugs were similar in both groups. Analysis of the disposition kinetics of parasitaemia, using a non-compartmental model similar to that used in characterizing drug disposition, showed that the two groups had similar half-lives of parasitaemia (t1/2pd), volumes of blood completely cleared of parasites per unit time (CLBpd), and parasite-clearance-time:t1/2pd ratios. Three children in the HP group, all aged < 3 years, progressed to cerebral malaria within 8 h of presentation, and another HP child presented with isolated trunkal ataxia, indicative of cerebellar involvement. No child in the non-HP group had any of the features of severe malaria. Although the clinical characteristics and responses to oral therapy of children with and without HP are therefore very similar, young children with HP appear to have an increased risk of developing other features of severe malaria.
在一个疟疾流行地区，对连续就诊的104名儿童进行了研究，这些儿童有或无恶性疟原虫高寄生虫血症（HP），研究了他们的临床特征以及对抗疟口服疗法的反应。就诊时，虽然52名有HP的儿童比52名无HP的儿童明显年幼且心率明显更高，但两组在疟疾症状或任何其他临床特征方面并无显著差异。两组对抗疟口服药物的反应相似。使用类似于表征药物处置的非房室模型对寄生虫血症的处置动力学进行分析，结果显示两组的寄生虫血症半衰期（t1/2pd）、单位时间内完全清除寄生虫的血液量（CLBpd）以及寄生虫清除时间与t1/2pd的比值相似。HP组中有3名儿童，年龄均<3岁，在就诊后8小时内发展为脑型疟疾，另一名HP儿童表现为孤立性躯干共济失调，提示小脑受累。非HP组中没有儿童出现严重疟疾的任何特征。因此，虽然有HP和无HP儿童的临床特征及对抗疟口服疗法的反应非常相似，但有HP的幼儿似乎发生其他严重疟疾特征的风险增加。
