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[特定化疗在治疗后4年内预防弓形虫性脉络膜视网膜炎复发中的疗效]

[Efficacy of specific chemotherapy in the prevention of recurrences of toxoplasmic chorioretinitis during the 4 years following the treatment].

作者信息

Timsit J C, Bloch-Michel E

出版信息

J Fr Ophtalmol. 1987;10(1):15-23.

PMID:3598056
Abstract

The effectiveness of a curative or preventive therapy in toxoplasmic retinochoroiditis is difficult to evaluate clinically. The goal of the present paper was to study the recurrence rate of ocular toxoplasmosis during a four years period following a Pyrimethamine-sulfadiazine therapy. Some case had received previous therapy (systemic steroids alone or in combination with Spiramycin) which had not effected a lasting cure. In this series of 54 patients diagnosed as having active toxoplasmosis chorioretinitis, the combination of Pyrimethamine and Sulfadiazine seems statistically more effective than other reported treatments. The recurrence rate in a four years follow up study was 40 percent. The benefit of the therapy is more obvious in severe toxoplasmosis uveitis (with severe vitreous reaction, high recurrence rate, macular lesions). The treatment was less effective when indicated after an ineffective previous therapy. The dosage and the duration of the therapy must be adapted to each case. No complication was experienced during the treatment. In order to prevent recurrent toxoplasmosis uveitis Pyrimethamine-Sulfadiazine therapy appears to be the only effective synergistic therapy.

摘要

临床上很难评估治疗性或预防性疗法对弓形虫性视网膜脉络膜炎的疗效。本文的目的是研究在接受乙胺嘧啶 - 磺胺嘧啶治疗后的四年期间眼部弓形虫病的复发率。一些病例曾接受过先前的治疗(单独使用全身类固醇或与螺旋霉素联合使用),但未实现持久治愈。在这组54例被诊断为患有活动性弓形虫性脉络膜视网膜炎的患者中,乙胺嘧啶和磺胺嘧啶联合使用在统计学上似乎比其他报道的治疗方法更有效。在一项为期四年的随访研究中,复发率为40%。该疗法在严重的弓形虫性葡萄膜炎(伴有严重玻璃体反应、高复发率、黄斑病变)中益处更为明显。在先前治疗无效后才进行该治疗时效果较差。治疗的剂量和持续时间必须根据每个病例进行调整。治疗期间未出现并发症。为预防复发性弓形虫性葡萄膜炎,乙胺嘧啶 - 磺胺嘧啶疗法似乎是唯一有效的协同疗法。

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