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217例肠道贾第虫病和阿米巴病患者的临床与治疗研究

[Clinical and therapeutic study of a group of 217 patients with intestinal giardiasis and amebiasis].

作者信息

Degrémont A, Stürchler D, Wolfensberger E, Osterwalder B

出版信息

Schweiz Med Wochenschr. 1981 Dec 26;111(52):2039-46.

PMID:6276972
Abstract

In 15 months of the years 1979-1980, 158 patients with giardiasis and 69 patients with intestinal amebiasis were diagnosed and treated in the outpatient department of the Swiss Tropical Institute. Repeated examination of merthiolate-iodine-formol-fixed stools was the method of choice for detecting intestinal protozoa. Parasitological investigation of duodenal fluid (Enterotest) was less effective. Fewer than 30% of the cases were symptomatic, usually mentioning diarrhea (73-85%) or abdominal discomfort (20-44%). Treatment was by ornidazole single dose (2 g in adults; 40 mg/kg in children) for asymptomatic cases and a five-day treatment schedule (2 X 500 mg/day in adults, 20 mg/day in children) for symptomatic cases. In amebiasis a luminal amebicide (diloxanide furoate) was prescribed in all instances after the first stool examination. Parasitological cure rates were excellent (95%) in all cases of giardiasis but only 59 and 65% respectively in cases of asymptomatic and symptomatic amebiasis. Drug tolerance was excellent. Ornidazole is the drug of choice for all forms of giardiasis, even in a single dose. As a luminal amebicide, however, its efficacy is not superior to other nitroimidazole derivatives.

摘要

在1979 - 1980年的15个月中,瑞士热带研究所门诊部诊断并治疗了158例贾第虫病患者和69例肠道阿米巴病患者。硫柳汞 - 碘 - 甲醛固定粪便的反复检查是检测肠道原生动物的首选方法。十二指肠液(肠检胶囊法)的寄生虫学检查效果较差。不到30%的病例有症状,通常表现为腹泻(73 - 85%)或腹部不适(20 - 44%)。无症状病例采用奥硝唑单剂量治疗(成人2g;儿童40mg/kg),有症状病例采用五日治疗方案(成人2×500mg/天,儿童20mg/天)。在阿米巴病中,首次粪便检查后均开具腔道杀阿米巴药(二氯尼特糠酸酯)。所有贾第虫病病例的寄生虫学治愈率极佳(95%),但无症状和有症状的阿米巴病病例的治愈率分别仅为59%和65%。药物耐受性良好。奥硝唑是所有形式贾第虫病的首选药物,即使单剂量使用。然而,作为腔道杀阿米巴药,其疗效并不优于其他硝基咪唑衍生物。

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