Bacq Y, Besnier J M, Duong T H, Pavie G, Metman E H, Choutet P
Service d'Hépatogastroentérologie, C.H.R. de Tours, France.
Hepatology. 1991 Dec;14(6):1066-9.
Fascioliasis is the parasitic infestation of the liver and biliary tract related to Fasciola hepatica. Bithionol is proposed as the treatment of choice for human fascioliasis without major side effects. However, the efficacy of bithionol has been evaluated in chronic but not in acute fascioliasis. In this study we report on the success of treatment with bithionol in 10 patients with fascioliasis, 8 having acute fascioliasis. The criteria for the diagnosis of fascioliasis were hypereosinophilia, positive immunoelectrophoresis and indirect hemagglutination. Bithionol was given orally to hospitalized patients at the daily dose of 25 mg/kg body wt for 10 days. Three patients with acute fascioliasis received a second course of bithionol 2 or 3 mo after the first because of the recurrence of diarrhea and fatigue in one patient and persistent hypereosinophilia in two patients. All patients were cured. The follow-up period after the first course of treatment was between 16 and 47 mo. No major side effects were observed. We conclude that bithionol is the drug of choice for both acute and chronic fascioliasis. Moreover, its oral administration may allow treatment of fascioliasis in outpatients who do not have serious symptoms.
肝片吸虫病是由肝片吸虫引起的肝脏和胆道寄生虫感染。硫双二氯酚被推荐为治疗人类肝片吸虫病的首选药物，且无严重副作用。然而，硫双二氯酚在慢性肝片吸虫病中的疗效已得到评估，但在急性肝片吸虫病中的疗效尚未评估。在本研究中，我们报告了硫双二氯酚治疗10例肝片吸虫病患者的成功案例，其中8例为急性肝片吸虫病。肝片吸虫病的诊断标准为嗜酸性粒细胞增多、免疫电泳阳性和间接血凝试验阳性。住院患者口服硫双二氯酚，每日剂量为25mg/kg体重，持续10天。3例急性肝片吸虫病患者在首次治疗后2或3个月接受了第二个疗程的硫双二氯酚治疗，原因是1例患者出现腹泻和疲劳复发，2例患者持续嗜酸性粒细胞增多。所有患者均治愈。第一个疗程治疗后的随访期为16至47个月。未观察到严重副作用。我们得出结论，硫双二氯酚是急性和慢性肝片吸虫病的首选药物。此外，口服给药可能使无症状的门诊患者也能接受肝片吸虫病治疗。
