Manterola Carlos, Mansilla Juan A, Fonseca Flery
Department of Surgery, Faculty of Medicine, Universidad de La Frontera, Casilla 54-D, Temuco, Chile.
World J Surg. 2005 Jun;29(6):750-3. doi: 10.1007/s00268-005-7691-6.
To determine the plasmatic and intracystal concentrations of albendazole sulfoxide (AS) and correlate them with the viability of the scolices in patients surgically treated for hepatic hydatid cysts (HHC) that received albendazole preoperatively, as an indirect way of evaluating the scolicide efficacy of the drug. A non-consecutive series of patients with uncomplicated HHC, underwent operation at the Department of Surgery, Regional Hospital of Temuco, Chile, between 2001 and 2002. The patients were given 10 mg/kg/day of albendazole for 4 days prior to the surgery. Intraoperative samples of venous blood and hydatid fluid were taken, in which the plasmatic concentration (PIC) and intracystal concentration (ICC) of AS were measured by means of high-performance liquid chromatography. With the remaining hydatid fluid, the viability of the scolices was examined. The following variables were taken into consideration: diameter, type of cyst, number of cysts, and development of cyst-biliary communications. Descriptive statistics were used in the calculation of medians, averages, and standard deviations, and analytical statistics were used for the comparison of continuous variables applying the t-test and the Mann-Whitney U-test. A total of 26 patients with HHC, with a median age of 39.5 years (range: 16-80 years); 16 were women (61.5%). Nineteen patients presented only one cyst (73.1%), and the diametric median of the cysts was 14.5 cm (range: 7-30). Fourteen patients presented univesicular cysts (53.9%), and the remaining 12 had multivesicular cysts (46.1%). The average PIC of AS in the whole series was 1.88 +/- 0.5 microg/ml and the ICC was 0.26 +/- 0.2 microg/ml. The ICC in viable hydatid cysts was 0.25 microg/ml versus 0.28 microg/ml in non-viable cysts (p = 0.7556). The absence of association between intracystal levels of AS and the viability of the scolices allows one to posit indirectly that albendazole is ineffective as a scolicidal agent administered preoperatively for 4 days.
为测定接受术前阿苯达唑治疗的肝包虫囊肿（HHC）手术患者中阿苯达唑亚砜（AS）的血浆和囊内浓度，并将其与头节活力相关联，以此作为评估该药物杀头节疗效的间接方法。2001年至2002年间，在智利特木科地区医院外科，对一系列非连续性的单纯性HHC患者进行了手术。患者在手术前4天给予10mg/kg/天的阿苯达唑。术中采集静脉血和包虫液样本，通过高效液相色谱法测定其中AS的血浆浓度（PIC）和囊内浓度（ICC）。利用剩余的包虫液检查头节的活力。考虑了以下变量：囊肿直径、囊肿类型、囊肿数量以及囊肿与胆管相通情况。描述性统计用于计算中位数、平均值和标准差，分析性统计用于应用t检验和曼-惠特尼U检验比较连续变量。共有26例HHC患者，中位年龄为39.5岁（范围：16 - 80岁）；16例为女性（61.5%）。19例患者仅出现一个囊肿（73.1%），囊肿直径中位数为14.5cm（范围：7 - 30）。14例患者为单房囊肿（53.9%），其余12例为多房囊肿（46.1%）。整个系列中AS的平均PIC为1.88±0.5μg/ml，ICC为0.26±0.2μg/ml。存活包虫囊肿中的ICC为0.25μg/ml，而非存活囊肿中的ICC为0.28μg/ml（p = 0.7556）。AS囊内水平与头节活力之间缺乏关联，这使得人们可以间接推断，术前4天给予阿苯达唑作为杀头节药物是无效的。
