Haralabidis S, Diakou A, Frydas S, Papadopoulos E, Mylonas A, Patsias A, Roilides E, Giannoulis E
Department of Parasitology and Parasitic Diseases, Veterinary Faculty, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Int J Immunopathol Pharmacol. 2008 Apr-Jun;21(2):429-35. doi: 10.1177/039463200802100223.
Hydatidosis is a usually asymptomatic chronic disease. In most patients who undergo surgery, hydatidosis is not resolved due to high recurrence rate. However, long-term treatment with albendazole has been found to have a significant efficacy that has been further improved when albendazole is combined with praziquantel and fat-rich diet. In this study a retrospective evaluation of the outcome of hydatidosis in 70 patients, was performed. In group A, a combined chemotherapy of albendazole plus praziquantel was given after surgical removal of cysts. In group B chemotherapy alone was administered without surgery. Sera of all patients were assayed for IgG, IgM, IgA and IgE antibodies by ELISA. In addition, ultrasonography (US) and/or computerized tomography (CT) scans were performed every 3 months for 18 months, and then, each year until the end of follow-up. The difference between the two kinds of treatment used in the present study was found to be not significant, nor was the difference of the shrinkage and extended calcification of the HCs between the two groups. However, the difference of the shrinkage of the HCs of more than 80%, as well as the extended calcifications of the cysts between the two groups were found to be statistically significant. In all patients high levels of IgG and IgA were detected, while IgE in group A and/or IgM in group B were marginally detected above the background level throughout the study. Level of IgG was strongly fluctuated and significantly decreased at 11.7 years after the end of chemotherapy, or at 8.5 years after relapses in group A, while was dramatically decreased at 3.6 years after the termination of chemotherapy in group B. Relapses occurred in 11.4% of patients within the first six months after end of chemotherapy. After additional chemotherapy with albendazole for 3-6 months, all of them were considered cured at 8.5 years of follow up.
包虫病是一种通常无症状的慢性疾病。在大多数接受手术的患者中，由于复发率高，包虫病无法得到根治。然而，已发现阿苯达唑长期治疗具有显著疗效，当阿苯达唑与吡喹酮及富含脂肪的饮食联合使用时，疗效会进一步提高。本研究对70例包虫病患者的治疗结果进行了回顾性评估。A组在手术切除囊肿后给予阿苯达唑加吡喹酮联合化疗。B组仅进行化疗，未做手术。通过酶联免疫吸附测定法（ELISA）检测所有患者血清中的IgG、IgM、IgA和IgE抗体。此外，在18个月内每3个月进行一次超声检查（US）和/或计算机断层扫描（CT），之后每年进行一次，直至随访结束。本研究中使用的两种治疗方法之间的差异不显著，两组之间包虫囊（HC）的缩小和钙化扩大情况的差异也不显著。然而，两组之间HC缩小超过80%以及囊肿钙化扩大的差异具有统计学意义。在所有患者中均检测到高水平的IgG和IgA，而在整个研究过程中，A组的IgE和/或B组的IgM仅在背景水平之上微量检测到。IgG水平波动剧烈，在化疗结束后11.7年或A组复发后8.5年显著下降，而在B组化疗结束后3.6年急剧下降。11.4%的患者在化疗结束后的前六个月内复发。在用阿苯达唑进行3 - 6个月的额外化疗后，在8.5年的随访中所有患者均被视为治愈。
