Bryceson A D, Chulay J D, Ho M, Mugambii M, Were J B, Muigai R, Chunge C, Gachihi G, Meme J, Anabwani G
Trans R Soc Trop Med Hyg. 1985;79(5):700-4. doi: 10.1016/0035-9203(85)90197-x.
Ten Kenyan patients with visceral leishmaniasis, unresponsive to sodium stibogluconate at a dose of 16 to 20 mg Sb/kg/day given for 30 to 98 days, have been studied clinically and immunologically and compared with 57 antimony-responsive patients. Pulmonary tuberculosis and previous treatment with antimonial drugs were the only factors which were more common in unresponsive patients. The degree of immunosuppression and rate of recovery of immunoreactivity did not differ between antimony-responsive and -unresponsive patients. Only one patient had never been treated before (primary unresponsiveness). In the other nine patients secondary unresponsiveness occurred after one or more treatment courses, suggesting that the parasite developed resistance to antimony. Antimony-unresponsiveness in visceral leishmaniasis is a serious problem numerically, clinically and economically. A plea is made that the initial treatment of visceral leishmaniasis should be adequate in dose and duration.
对10名肯尼亚内脏利什曼病患者进行了临床和免疫学研究，并与57名对锑有反应的患者进行了比较。这10名患者接受葡萄糖酸锑钠治疗，剂量为16至20毫克锑/千克/天，持续30至98天，但无反应。肺结核和既往使用锑剂治疗是无反应患者中更为常见的唯一因素。有反应和无反应患者之间的免疫抑制程度和免疫反应恢复率没有差异。只有1名患者此前从未接受过治疗（原发性无反应）。其他9名患者在一个或多个疗程后出现继发性无反应，提示寄生虫对锑产生了耐药性。内脏利什曼病的锑无反应在数量、临床和经济方面都是一个严重问题。有人呼吁内脏利什曼病的初始治疗在剂量和疗程上应足够。
