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在三年随访期间对南里奥格兰德州无症状恰加斯病患者进行苯硝唑治疗的疗效评估。

Efficacy of benznidazol treatment for asymptomatic chagasic patients from state of Rio Grande do Sul evaluated during a three years follow-up.

作者信息

Fernandes C D, Tiecher F M, Balbinot M M, Liarte D B, Scholl D, Steindel M, Romanha A

机构信息

Instituto de Pesquisa Biológica, Laboratório Central, Fundação Estadual de Produção e Pesquisa em Saúde, Porto Alegre, RS, Brasil.

出版信息

Mem Inst Oswaldo Cruz. 2009 Feb;104(1):27-32. doi: 10.1590/s0074-02762009000100004.

Abstract

The efficacy of benznidazol on the treatment of chagasic patients from the state of Rio Grande do Sul was evaluated during a three-year follow-up. A cohort of 80 asymptomatic chronic chagasic patients or blood bank donors (49 male and 31 female) was studied. Their ages varied from 17-42 years, with a mean and a median of 30 and 35 years, respectively. The 80 patients presented positive serology, hemoculture and polymerase chain reaction (PCR). They were treated with 5 mg/Kg benznidazol twice a day for 60 days. Serological, parasitological and PCR methods were used to evaluate response. Serology was performed using commercial ELISA and indirect immunofluorescence (IFI) tests, parasitemia was monitored by hemoculture in LIT medium and PCR with primers S35/S36 was used to amplify a Trypanosoma cruzi 330 bp kDNA repetitive sequence. PCR positivity of 240 seropositive individuals was compared using DNA preparations from whole blood/guanidine EDTA (GE), buffy-coat/GE and frozen buffy-coat. Fifty non-chagasic individuals were used as negative controls. PCR positivity was 86.7% for the frozen buffy-coat, 71.7% for the GE/buffy-coat and 69.2% for the GE/whole blood. The hemocultures became negative just after treatment and remained negative during the three years of follow-up. In the third year after treatment, 9/80 (11.3%) patients presented negative PCR and, from those, four also presented negative serological tests. Furthermore, a reduction in three serological titers was observed in 27/80 (33.8%) of the patients treated. Taken together, the results show that four of the 80 (5.0%) chronic chagasic patients from the state of Rio Grande do Sul were cured after treatment with benznidazol.

摘要

在三年的随访期间,评估了苯硝唑对南里奥格兰德州恰加斯病患者的治疗效果。研究了一组80名无症状慢性恰加斯病患者或血库献血者(49名男性和31名女性)。他们的年龄在17至42岁之间,平均年龄为30岁,中位数为35岁。这80名患者的血清学、血培养和聚合酶链反应(PCR)均呈阳性。他们接受了每天两次、每次5mg/Kg苯硝唑的治疗,持续60天。采用血清学、寄生虫学和PCR方法评估治疗反应。血清学检测使用商业酶联免疫吸附测定(ELISA)和间接免疫荧光(IFI)试验,通过在LIT培养基中进行血培养监测寄生虫血症,并使用引物S35/S36的PCR扩增克氏锥虫330bp kDNA重复序列。使用全血/胍乙二胺四乙酸(GE)、血沉棕黄层/GE和冷冻血沉棕黄层的DNA制剂比较240名血清阳性个体的PCR阳性率。50名非恰加斯病个体用作阴性对照。冷冻血沉棕黄层的PCR阳性率为86.7%,GE/血沉棕黄层为71.7%,GE/全血为69.2%。血培养在治疗后立即转阴,并在三年随访期间一直保持阴性。治疗后第三年,80名患者中有9名(11.3%)PCR呈阴性,其中4名血清学检测也呈阴性。此外,在接受治疗的80名患者中有27名(33.8%)观察到三种血清学滴度降低。综上所述,结果表明,南里奥格兰德州的80名慢性恰加斯病患者中有4名(5.0%)在接受苯硝唑治疗后治愈。

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