己酮可可碱在儿童脑型疟疾中的辅助治疗作用。
Pentoxifylline as an adjunct therapy in children with cerebral malaria.
机构信息
KEMRI Centre for Geographic Medicine Research (Coast), Kilifi, Kenya.
出版信息
Malar J. 2010 Dec 21;9:368. doi: 10.1186/1475-2875-9-368.
BACKGROUND
Pentoxifylline (PTX) affects many processes that may contribute to the pathogenesis of severe malaria and it has been shown to reduce the duration of coma in children with cerebral malaria. This pilot study was performed to assess pharmacokinetics, safety and efficacy of PTX in African children with cerebral malaria.
METHODS
Ten children admitted to the high dependency unit of the Kilifi District Hospital in Kenya with cerebral malaria (Blantyre coma score of 2 or less) received quinine plus a continuous infusion of 10 mg/kg/24 hours PTX for 72 hours. Five children were recruited as controls and received normal saline instead of PTX. Plasma samples were taken for PTX and tumour necrosis factor (TNF) levels. Blantyre Coma Score, parasitemia, hematology and vital signs were assessed 4 hourly.
RESULTS
One child (20%) in the control group died, compared to four children (40%) in the PTX group. This difference was not significant (p = 0.60). Laboratory parameters and clinical data were comparable between groups. TNF levels were lower in children receiving PTX.
CONCLUSIONS
The small sample size does not permit definitive conclusions, but the mortality rate was unexpectedly high in the PTX group.
背景
己酮可可碱（PTX）可影响多种可能导致重症疟疾发病的过程，且已证实其可缩短脑型疟疾患儿的昏迷时间。本试验旨在评估 PTX 在非洲脑型疟疾患儿中的药代动力学、安全性和疗效。
方法
肯尼亚基利菲区医院重症监护病房收治的 10 名脑型疟疾患儿（Blantyre 昏迷评分 2 分或更低）接受奎宁加 10mg/kg/24 小时持续输注 72 小时的 PTX。其中 5 名患儿作为对照，接受生理盐水而非 PTX。采集血浆样本以检测 PTX 和肿瘤坏死因子（TNF）水平。每 4 小时评估 Blantyre 昏迷评分、寄生虫血症、血液学和生命体征。
结果
对照组有 1 名患儿（20%）死亡，PTX 组有 4 名患儿（40%）死亡。差异无统计学意义（p=0.60）。两组的实验室参数和临床数据相似。接受 PTX 治疗的患儿 TNF 水平较低。
结论
由于样本量小，无法得出明确结论，但 PTX 组的死亡率出人意料地高。
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