King C H, Lombardi G, Lombardi C, Greenblatt R, Hodder S, Kinyanjui H, Ouma J, Odiambo O, Bryan P J, Muruka J
Case Western Reserve University, Cleveland, Ohio.
Am J Trop Med Hyg. 1990 Jun;42(6):587-95. doi: 10.4269/ajtmh.1990.42.587.
To determine the relative efficacy of metrifonate and praziquantel in controlling urinary tract morbidity due to Schistosoma haematobium infection, a random allocation treatment trial was performed among 1,813 school age S. haematobium-infected children from the Msambweni area of Coast Province, Kenya. Following baseline examination for infection, hematuria, proteinuria, and ultrasonographic urinary tract abnormalities, oral treatment with either metrifonate (10 mg/kg, repeated at 4 month intervals) or praziquantel (1 dose of 40 mg/kg) was given to infected subjects. Prevalence of morbidity was reassessed 12 months later for each treatment group. Results indicated equivalent patient improvement in response to either regimen: prevalence of hematuria fell from 75% to 17% after either praziquantel or metrifonate therapy. Similarly, prevalence of proteinuria was significantly reduced from 73% to 29% (metrifonate) or 27% (praziquantel) after therapy. Metrifonate and praziquantel caused similar reductions in bladder granulomata and bladder thickening; however, no reduction in hydronephrosis was noted with either drug. Analysis of outcomes in population subgroups defined by age, sex, pretreatment intensity of infection, or severity of pretreatment morbidity showed no consistent advantage for either drug. In this endemic area, both agents provide effective control of morbidity due to urinary schistosomiasis.
为确定敌百虫和吡喹酮在控制埃及血吸虫感染所致尿路疾病方面的相对疗效，在肯尼亚海岸省姆桑布韦尼地区1813名感染埃及血吸虫的学龄儿童中进行了一项随机分配治疗试验。在对感染、血尿、蛋白尿和超声检查尿路异常进行基线检查后，对感染受试者给予口服敌百虫（10mg/kg，每4个月重复一次）或吡喹酮（一剂40mg/kg）治疗。12个月后对每个治疗组的疾病患病率进行重新评估。结果表明，两种治疗方案对患者的改善效果相当：吡喹酮或敌百虫治疗后，血尿患病率从75%降至17%。同样，治疗后蛋白尿患病率从73%显著降至29%（敌百虫）或27%（吡喹酮）。敌百虫和吡喹酮对膀胱肉芽肿和膀胱增厚的减轻作用相似；然而，两种药物均未观察到肾积水减轻。对按年龄、性别、治疗前感染强度或治疗前疾病严重程度定义的人群亚组的结果分析表明，两种药物均无持续优势。在这个流行地区，两种药物都能有效控制尿路血吸虫病所致疾病。
