Hien Tran Tinh, Truong Ng Thanh, Minh Nguyen Hoang, Dat Hoang Dinh, Dung Nguyen Thi, Hue Nguyen Thi, Dung Tran Kim, Tuan Phung Quoc, Campbell James I, Farrar Jeremy J, Day Jeremy N
Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
Am J Trop Med Hyg. 2008 Mar;78(3):388-92.
Human fascioliasis caused by Fasciola hepatica or Fasciola gigantica is an increasing global problem. The mainstay of current treatment is triclabendazole, but resistance in animals has been described, and it is not available in many countries. The antimalarial artesunate has an excellent safety profile, and there is increasing evidence of its efficacy against other parasites both in vitro and in vivo. We performed a study to investigate the usefulness of artesunate in symptomatic human fascioliasis; 100 patients were enrolled. Patients treated with artesunate were significantly more likely to be free of abdominal pain at hospital discharge (50/50 versus 44/50, P = 0.027, relative risk 1.14, 95% confidence interval 1.03-1.26), but the complete response rate at 3 months was lower than for patients treated with triclabendazole (38/50 versus 46/50, P = 0.05, RR 0.83, 95% CI 0.69-0.98, artesunate versus triclabendazole). There may be a role for artesunate in fascioliasis.
由肝片吸虫或巨片吸虫引起的人体片形吸虫病是一个日益严重的全球性问题。当前治疗的主要药物是三氯苯达唑，但已发现动物对其产生耐药性，且在许多国家无法获取该药物。抗疟药青蒿琥酯具有出色的安全性，越来越多的证据表明其在体外和体内对其他寄生虫均有效。我们开展了一项研究，以调查青蒿琥酯对有症状的人体片形吸虫病的疗效；共纳入100例患者。接受青蒿琥酯治疗的患者在出院时腹痛消失的可能性显著更高（50/50 对比 44/50，P = 0.027，相对风险1.14，95%置信区间1.03 - 1.26），但3个月时的完全缓解率低于接受三氯苯达唑治疗的患者（38/50 对比 46/50，P = 0.05，RR 0.83，95% CI 0.69 - 0.98，青蒿琥酯对比三氯苯达唑）。青蒿琥酯在片形吸虫病治疗中可能有一定作用。
