Yasawy M I, Alkarawi M A, Mohammed A R
Department of Gastroenterology, Armed forces Hospital, Riyadh, Saudi Arabia.
Hepatogastroenterology. 2001 Sep-Oct;48(41):1467-70.
Both benzimidazoles (albendazole) and isoquineline compounds (praziquantel) have activity against. We reviewed the efficiency of benzimidazole and isoquineline in the management of hepatic Echinococcus in our clinical cases and the other laboratory and animal studies. Until recently, surgery was the only treatment of choice. Albendazole introduction and its early results were exciting. In 1985, a favorable outcome of a combination of albendazole and praziquantel was described and lately indications for pre- and postoperative prophylactic usage has been established. Both drugs in animal and laboratory studies by different authors and our own clinical experiences were reviewed and the effectiveness for both therapeutic and prophylaxis purposes were studied. Albendazole in the treatment of Echinococcus granulosus is shown to be superior to other benzimidazoles and a combination of albendazole and praziquantel is more effective than albendazole alone. Albendazole therapy is associated with a 50% disappearance of cysts and in others has caused shrinkage, cyst wall and interacystic changes. Pre- and postoperative prophylactic therapy is effective and side effects with regular follow-up and evaluation are not serious. Long-term follow-up showed a 30% recurrence rate, whereas, in contrast, combination therapy required a shorter period of therapy but long-term outcome and recurrence are still to be evaluated. In conclusion chemotherapy is an essential part of management. Combination therapy is more effective and requires a shorter period of treatment than albendazole alone. Pre- and postoperative prophylactic therapy reduce risk of spillage and dissemination during surgery and percutaneous aspiration. Chemotherapy failure could be due to a number of factors such as pharmacokinetics and queries different strains of parasites which should not prevent its usage as an essential part of management.
苯并咪唑类药物（阿苯达唑）和异喹啉类化合物（吡喹酮）均具有抗……活性。我们回顾了苯并咪唑类和异喹啉类药物在我们临床病例以及其他实验室和动物研究中治疗肝包虫病的疗效。直到最近，手术仍是唯一的治疗选择。阿苯达唑的引入及其早期结果令人振奋。1985年，有人描述了阿苯达唑与吡喹酮联合使用的良好效果，最近还确立了术前和术后预防性使用的指征。我们回顾了不同作者在动物和实验室研究中使用这两种药物的情况以及我们自己的临床经验，并研究了它们在治疗和预防方面的有效性。结果表明，阿苯达唑在治疗细粒棘球绦虫方面优于其他苯并咪唑类药物，阿苯达唑与吡喹酮联合使用比单独使用阿苯达唑更有效。阿苯达唑治疗可使囊肿消失50%，在其他情况下可导致囊肿缩小、囊壁及囊间变化。术前和术后预防性治疗有效，定期随访和评估的副作用不严重。长期随访显示复发率为30%，相比之下，联合治疗所需治疗时间较短，但长期疗效和复发情况仍有待评估。总之，化疗是治疗的重要组成部分。联合治疗比单独使用阿苯达唑更有效，且所需治疗时间更短。术前和术后预防性治疗可降低手术和经皮穿刺抽吸过程中囊肿破裂和播散的风险。化疗失败可能由多种因素导致，如药代动力学以及对不同寄生虫菌株的疑问，但这不应妨碍将其作为治疗的重要组成部分使用。
