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恶性疟原虫疟疾:加蓬对氯喹耐药,但对甲氟喹敏感。一项前瞻性体外研究。

Plasmodium falciparum-malaria: resistance to chloroquine, but sensitivity to mefloquine in the Gabon. A prospective in-vitro study.

作者信息

Burchard G D, Horstmann R D, Wernsdorfer W H, Dietrich M

出版信息

Tropenmed Parasitol. 1984 Mar;35(1):1-4.

PMID:6369691
Abstract

A determination of the sensitivity to chloroquine and to mefloquine was carried out in malaria patients of the Albert Schweitzer Hospital, Lambarene, Gabon, by using the schizont maturation test. The chloroquine testing showed in 6 of 31 cases a schizont maturation at 1.14 pmol/microliter of blood and more; this means an in-vitro resistance in 19% of the cases. The evaluation of the effective concentrations (i.e. concentrations producing the appropriate inhibition of schizont maturation) with the probit analysis yielded for chloroquine an EC50 of 0.2537 X 10(-6) mol/l of blood and an EC90 of 0.8317 X 10(-6) mol/l of blood. In the testing of mefloquine, schizont maturation was found in 3 of 31 cases in concentrations of 1.6 pmol/microliter of blood, the probit analysis, however, showed effective doses in the normal range with an EC50 of 0.2192 X 10(-6) mol/l of blood and an EC90 of 0.7863 X 10(-6) mol/l of blood. These results demonstrate the alarming observation of Plasmodium falciparum strains resistant in-vitro to chloroquine in a region where in vivo resistance has not been observed hitherto.

摘要

在加蓬兰巴雷内阿尔贝特·施韦泽医院的疟疾患者中,通过使用裂殖体成熟试验,对氯喹和甲氟喹的敏感性进行了测定。氯喹检测显示,在31例病例中有6例在血药浓度为1.14皮摩尔/微升及以上时出现裂殖体成熟;这意味着19%的病例存在体外耐药性。用概率分析评估有效浓度(即产生适当抑制裂殖体成熟的浓度),氯喹的半数有效浓度(EC50)为0.2537×10⁻⁶摩尔/升血液,90%有效浓度(EC90)为0.8317×10⁻⁶摩尔/升血液。在甲氟喹检测中,31例病例中有3例在血药浓度为1.6皮摩尔/微升时出现裂殖体成熟,然而概率分析显示有效剂量在正常范围内,EC50为0.2192×10⁻⁶摩尔/升血液,EC90为0.7863×10⁻⁶摩尔/升血液。这些结果表明,在一个迄今尚未观察到体内耐药性的地区,出现了体外对氯喹耐药的恶性疟原虫菌株,这一观察结果令人担忧。

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