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[吡喹酮治疗人体包虫病。术前治疗的评估]

[Praziquantel in human hydatidosis. Evaluation by preoperative treatment].

作者信息

Piens M A, Persat F, May F, Mojon M

机构信息

Laboratoire de Parasitologie et Pathologie Tropicale, Faculté de Médecine, Lyon.

出版信息

Bull Soc Pathol Exot Filiales. 1989;82(4):503-12.

PMID:2805182
Abstract

The efficacy of praziquantel has been studied in human hydatic disease due to E. granulosus, using parasitological and pharmacological criteria of improvement. This evaluation uses a prospective therapeutic trial in 15 patients with one or several hydatic cysts in different sites. Before surgery, nine of these received daily 75 mg/kg of praziquantel in 2 courses of 10 days each. The other six patients are considered as controls. The protoscolices vitality is determined by direct optic microscopy and by intraperitoneal mouse inoculation. According to the results of optic microscopy, praziquantel sterilizes hydatic cysts: 19 sterilized cysts out of 26 coming from treated patients, and 4 out of 11 in control group. This effect seems to be emphasized in hepatic localization. Nevertheless, according to the results of mouse inoculation, praziquantel does not significantly reduce the pathogenicity of inoculated proscolices and germinal layer: 11 mice out of 39 are healthy in the treated group, and 5 out of 15 in controls. Moreover, the determination with a fluorimetric method has not detected praziquantel in the hydatid liquid issued from treated patients. The drug does not pass through the cyst wall, and so, cannot have a scolicidal activity. Praziquantel cannot be considered as a medical treatment in human hydatidosis.

摘要

已根据寄生虫学和药理学改善标准,对吡喹酮治疗人体细粒棘球绦虫所致包虫病的疗效进行了研究。本评估采用前瞻性治疗试验,对15例不同部位有一个或多个包虫囊肿的患者进行研究。手术前,其中9例患者每天接受75mg/kg吡喹酮治疗,分两个疗程,每个疗程10天。另外6例患者作为对照。原头蚴活力通过直接光学显微镜检查和腹腔小鼠接种来确定。根据光学显微镜检查结果,吡喹酮可使包虫囊肿失活:治疗组26个囊肿中有19个失活,对照组11个囊肿中有4个失活。这种效果在肝脏定位中似乎更为明显。然而,根据小鼠接种结果,吡喹酮并未显著降低接种原头蚴和生发层的致病性:治疗组39只小鼠中有11只健康,对照组15只小鼠中有5只健康。此外,荧光法测定未在治疗患者的包虫液中检测到吡喹酮。该药物无法穿过囊肿壁,因此不具有杀头节活性。吡喹酮不能被视为治疗人类包虫病的药物。

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