Gil-Grande L A, Rodriguez-Caabeiro F, Prieto J G, Sánchez-Ruano J J, Brasa C, Aguilar L, García-Hoz F, Casado N, Bárcena R, Alvarez A I, Dal-Ré R
Department of Gastroenterology, Hospital Ramón y Cajal, Madrid, Spain.
Lancet. 1993 Nov 20;342(8882):1269-72. doi: 10.1016/0140-6736(93)92361-v.
The efficacy of albendazole in hydatid disease is still unclear, because there has been no study that assessed the status of the parasite after treatment. The significance of albendazole-induced echographic changes in the cyst therefore cannot be judged. We did a prospective, controlled, randomised, open study of albendazole in patients with liver hydatid disease, and assessed parasite viability after treatment. 18 patients received no albendazole treatment (controls), 18 received albendazole (10 mg/kg daily) for 1 month (group A), and 19 received the drug for about 3 months (group B). Echography was done before and during treatment; all patients underwent surgery on completion. Parasite (protoscolex viability and development of cysts in mice) and ultrastructure studies were done for all cysts removed. 8 (50%) of cysts in the control group, 13 (72%) in group A, and 16 (94%) in group B were non-viable (p = 0.015). Protoscolex and cyst viability were significantly (p = 0.039 and p = 0.018, respectively) lower in treated patients than in controls. Treatment was also significantly associated with total cyst membrane disintegration. 68% of cysts treated for 3 months showed echographic changes, and only 1 of 20 cysts showing echographic changes during treatment was judged viable. The efficacy of albendazole at a dose of 10 mg/kg daily for 3 months suggests that it is a suitable alternative to surgery in uncomplicated hydatid liver disease, as initial treatment.
阿苯达唑治疗包虫病的疗效仍不明确，因为尚无研究评估治疗后寄生虫的状态。因此，无法判断阿苯达唑引起的囊肿超声变化的意义。我们对肝包虫病患者进行了一项关于阿苯达唑的前瞻性、对照、随机、开放研究，并评估了治疗后寄生虫的活力。18例患者未接受阿苯达唑治疗（对照组），18例接受阿苯达唑（每日10mg/kg）治疗1个月（A组），19例接受该药治疗约3个月（B组）。在治疗前和治疗期间进行超声检查；所有患者在完成治疗后均接受手术。对所有切除的囊肿进行寄生虫（原头节活力和小鼠囊肿发育）及超微结构研究。对照组8个（50%）囊肿、A组13个（72%）囊肿和B组16个（94%）囊肿无活力（p=0.015）。治疗患者的原头节和囊肿活力显著低于对照组（分别为p=0.039和p=0.018）。治疗还与囊肿总膜崩解显著相关。接受3个月治疗的囊肿中有68%出现超声变化，在治疗期间出现超声变化的20个囊肿中只有1个被判定有活力。每日剂量为10mg/kg、持续3个月的阿苯达唑疗效表明，作为初始治疗，它是单纯性肝包虫病手术的合适替代方法。
