Center for Global Pediatrics, 717 Delaware Street SE, Room 363, Minneapolis, MN 55455, USA.
Expert Rev Anti Infect Ther. 2010 Sep;8(9):997-1008. doi: 10.1586/eri.10.90.
Severe malaria due to Plasmodium falciparum causes more than 800,000 deaths every year. Primary therapy with quinine or artesunate is generally effective in controlling P. falciparum parasitemia, but mortality from cerebral malaria and other forms of severe malaria remains unacceptably high. Long-term cognitive impairment is also common in children with cerebral malaria. Of the numerous adjunctive therapies for cerebral malaria and severe malaria studied over the past five decades, only one (albumin) was associated with a reduction in mortality. In this article, we review past and ongoing studies of adjunctive therapy, and examine the evidence of efficacy for newer therapies, including inhibitors of cytoadherence (e.g., levamisole), immune modulators (e.g., rosiglitazone), agents that increase nitric oxide levels (e.g., arginine) and neuroprotective agents (e.g., erythropoietin).
每年有超过 80 万人死于恶性疟原虫引起的严重疟疾。奎宁或青蒿琥酯的主要治疗方法通常能有效控制疟原虫血症，但脑型疟疾和其他严重疟疾的死亡率仍然高得令人无法接受。患有脑型疟疾的儿童也常常存在长期认知障碍。在过去五十年中，对脑型疟疾和严重疟疾进行了大量辅助治疗研究，只有一种（白蛋白）与降低死亡率相关。本文回顾了过去和正在进行的辅助治疗研究，并检查了新疗法的疗效证据，包括细胞黏附抑制剂（如左旋咪唑）、免疫调节剂（如罗格列酮）、增加一氧化氮水平的药物（如精氨酸）和神经保护剂（如促红细胞生成素）。
