Di Perri G, Di Perri I G, Monteiro G B, Bonora S, Hennig C, Cassatella M, Micciolo R, Vento S, Dusi S, Bassetti D
Institute of Immunology, University of Verona, Italy.
J Infect Dis. 1995 May;171(5):1317-22. doi: 10.1093/infdis/171.5.1317.
In an open, randomized, controlled therapeutic trial, 56 children with cerebral malaria (CM) were randomly assigned to receive standard quinine regimen with or without pentoxifylline (10 mg/kg/day by continuous intravenous infusion). Pentoxifylline exerted an inhibitory effect on the synthesis of tumor necrosis factor (TNF), a possible mediator of CM. The 26 children who received pentoxifylline had significantly shorter comas than controls (median, 6 vs. 46 h; P < .001) Pentoxifylline recipients showed a trend toward a lower mortality, with a borderline significant difference (P = .055). The better outcome in the pentoxifylline group was associated with a decline in TNF serum levels on the third day of treatment in a few subjects that was not seen in controls. While alternative or concurrent mechanisms of action may be of some relevance, larger double-blind trials are needed to determine whether pentoxifylline has a therapeutic role in CM.
在一项开放性、随机、对照治疗试验中，56名脑型疟疾（CM）患儿被随机分配接受标准奎宁治疗方案，部分患儿同时接受己酮可可碱治疗（通过持续静脉输注，剂量为10mg/kg/天）。己酮可可碱对肿瘤坏死因子（TNF）的合成具有抑制作用，而TNF可能是脑型疟疾的一种介质。接受己酮可可碱治疗的26名患儿昏迷时间明显短于对照组（中位数分别为6小时和46小时；P <.001）。接受己酮可可碱治疗的患儿死亡率有降低趋势，差异接近显著水平（P = 0.055）。己酮可可碱治疗组较好的治疗效果与部分受试者治疗第三天血清TNF水平下降有关，而对照组未出现这种情况。虽然其他作用机制或并发机制可能也有一定关联，但仍需要更大规模的双盲试验来确定己酮可可碱在脑型疟疾治疗中是否具有治疗作用。
