Guderian R H, Anselmi M, Beck B J, Mackenzie C D, Williams J F, Proaño J R, Cooper P J
Onchocerciasis Project, Community Development Vozandes, Hospital Vozandes, Quito, Ecuador.
Trans R Soc Trop Med Hyg. 1991 Sep-Oct;85(5):634-8. doi: 10.1016/0035-9203(91)90372-6.
The effect of chloroquine phosphate on Onchocerca volvulus in vivo was studied in Ecuadorians undergoing treatment for malaria. All persons with a diagnosis of acute malaria and treated with 2500 mg of chloroquine over 3 d showed a 100% reduction of dermal O. volvulus microfilariae 7 d after treatment. However, 28 d after treatment the microfilarial densities returned to their pre-treatment levels and at 35 d they had increased to 121.6% of their pre-treatment values. Treatment did not appear to have any effect on the adult O. volvulus examined histologically in extirpated nodules. Patients treated for acute malaria and subsequently kept on a prophylactic regimen of 500 mg chloroquine weekly showed a reduction of 56.7% from pre-treatment microfilarial density after 27 weeks. Patients who underwent nodulectomy as well as treatment for acute malaria and were given 500 mg of chloroquine prophylactically for 27 weeks showed a reduction in dermal microfilarial density of 93.6%. Symptoms of onchocerciasis were reduced in the latter group of patients, with the elimination of all acute dermatological changes within 6 weeks. Ocular examination of these surgically and chemotherapeutically treated individuals revealed reductions of 94.9% of microfilariae in the anterior chamber, 95.9% of live microfilariae in the cornea, and 95.1% of dead microfilariae in the cornea. There was a reduction of 69.8% in corneal fluffy opacities. No alteration in the visual acuity or in visible lesions in the posterior segment was recorded. The results suggest that a complex interaction between chloroquine and O. volvulus takes place in vivo, which can be beneficial to the patient over a long period.(ABSTRACT TRUNCATED AT 250 WORDS)
在接受疟疾治疗的厄瓜多尔人中，研究了磷酸氯喹对体内旋盘尾丝虫的作用。所有被诊断为急性疟疾并在3天内接受2500毫克氯喹治疗的人，在治疗7天后，皮肤内的旋盘尾丝虫微丝蚴减少了100%。然而，治疗28天后，微丝蚴密度恢复到治疗前水平，35天时增加到治疗前值的121.6%。治疗似乎对切除结节中经组织学检查的成虫旋盘尾丝虫没有任何影响。接受急性疟疾治疗并随后维持每周500毫克氯喹预防方案的患者，在27周后微丝蚴密度比治疗前降低了56.7%。接受结节切除术以及急性疟疾治疗并接受500毫克氯喹预防性治疗27周 的患者，其皮肤微丝蚴密度降低了93.6%。后一组患者的盘尾丝虫病症状有所减轻，在6周内消除了所有急性皮肤病变。对这些接受手术和化疗的个体进行眼部检查发现，前房中的微丝蚴减少了94.9%，角膜中的活微丝蚴减少了95.9%，角膜中的死微丝蚴减少了95.1%。角膜蓬松混浊减少了69.8%。未记录到视力或后节可见病变的改变。结果表明，氯喹与旋盘尾丝虫在体内发生复杂的相互作用，长期来看对患者可能有益。（摘要截短为250字）
