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[抗疟药物的临床评估]

[Clinical evaluation of antimalarial drugs].

作者信息

Tanabe K, Shimada K

机构信息

Department of Infectious Diseases, University of Tokyo.

出版信息

Kansenshogaku Zasshi. 1990 Jun;64(6):668-73. doi: 10.11150/kansenshogakuzasshi1970.64.668.

DOI:10.11150/kansenshogakuzasshi1970.64.668
PMID:2205671
Abstract

We have analyzed the clinical data of 189 patients with malaria to establish antimalarial regimens in Japan. The causative parasite species were Plasmodium falciparum in 56 cases (30%), P. vivax in 132 (70%) and P. malariae in 1 (1%). The outcomes f malaria cases are as follows: Cure rats in falciparum and vivax malaria are 86% and 91%, respectively. Two patients died of falciparum malaria and recurrence occurred in 6 cases (11%) of falciparum malaria. Relapse was seen in 12 (9%) of vivax malaria. Chloroquine was most frequently used among antimalarial agents (in 123 cases, 65% of the total) for suppressing acute attacks. The efficacy of chloroquine was evaluated by classifying each case into three groups: chloroquine alone in group one, chloroquine in combination with other antimalarials in group two and other antimalarials except chloroquine in group three. The cure rate among each group is about 80% and there is no difference among them. However, it is noticeable that recurrence occurred when patients were treated with a combination of chloroquine and quinine. We have found a similar result as this in another old report in Japan. Primaquine is effective for eliminating hepatic tissue schizonts but in this study, relapse occurred in 12 cases of vivax, although primaquine had been used in 10 out of 12 cases. In primaquine group, relapse occurred at a similar rate between chloroquine and Fansidar cases. Further studies are needed to decide whether a larger dose of primaquine is appropriate for treatment of vivax malaria. Recovery periods from fever and parasitemia were compared between chloroquine and Fansidar cases.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们分析了189例疟疾患者的临床数据,以确立日本的抗疟治疗方案。致病寄生虫种类为:恶性疟原虫56例(30%),间日疟原虫132例(70%),三日疟原虫1例(1%)。疟疾病例的结果如下:恶性疟和间日疟的治愈率分别为86%和91%。2例患者死于恶性疟疾,6例(11%)恶性疟疾病例复发。12例(9%)间日疟出现复发。在抗疟药物中,氯喹最常用于抑制急性发作(123例,占总数的65%)。氯喹的疗效通过将每个病例分为三组进行评估:第一组单用氯喹,第二组氯喹与其他抗疟药联用,第三组使用除氯喹以外的其他抗疟药。每组的治愈率约为80%,组间无差异。然而,值得注意的是,氯喹和奎宁联用时出现了复发情况。我们在日本的另一篇旧报告中也发现了类似结果。伯氨喹对消除肝组织裂殖体有效,但在本研究中,12例间日疟患者中有12例复发,尽管其中10例使用了伯氨喹。在伯氨喹组中,氯喹和Fansidar(磺胺多辛-乙胺嘧啶)病例的复发率相似。需要进一步研究以确定更大剂量的伯氨喹是否适合治疗间日疟。比较了氯喹和Fansidar病例的退热期和寄生虫血症恢复期。(摘要截选至250字)

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