Wen H, Zou P F, Yang W G, Lu J, Wang Y H, Zhang J H, New R R, Craig P S
Department of Surgery, Xinjiang Medical College, Urumqi, Xinjiang, China.
Trans R Soc Trop Med Hyg. 1994 May-Jun;88(3):340-3. doi: 10.1016/0035-9203(94)90108-2.
Human echinococcosis is highly endemic in north-western China; the main treatment is by surgery. In this paper, we report the results of chemotherapy with albendazole (ABZ), 15-20 mg/kg/d orally, for 30 d with intervals of 10 d between treatments for 3-6 courses. For multi-organ cystic echinococcosis (CE) and alveolar echinococcosis (AE), patients were given 12-18 courses of ABZ. Patients were divided into 4 groups: (i) ABZ surgery group, albendazole with surgery for 21 CE cases: (ii) non-ABZ surgery group, 80 CE cases treated by surgery alone; (iii) ABZ CE group, albendazole treatment alone in 58 CE cases, and (iv) ABZ AE group, 14 AE patients treated by albendazole and surgical intervention and 5 AE patients treated by albendazole alone. Twenty-seven of 34 (79.4%) cysts in group (i) patients showed increased necrotic changes and decreased viability of the cysts compared to group (ii). However, 10 of 84 (11.9%) cysts in group (ii) patients showed spontaneous evidence of necrosis at surgery. In group (iii), ABZ treatment alone was successful in 14 (24.1%), resulted in improvement in 29 (50%) and had no effect in 15 (25.9%) patients. Seven cases in group (iv) improved, with diminished size of lesions which were non-viable. The remaining 7 cases in group (iv) showed evidence of cyst viability at surgery; 2 could not be saved after a further 15 courses of albendazole. Of the five AE patients in group (iv) who received only ABZ, one improved, 2 stabilized, one deteriorated and one died. Albendazole chemotherapy, while not completely effective, has an important role in treatment of both cystic and alveolar echinococcosis.
泡型包虫病在中国西北地区高度流行；主要治疗方法是手术。在本文中，我们报告了阿苯达唑（ABZ）化疗的结果，口服剂量为15 - 20mg/kg/d，持续30天，治疗间隔为10天，共进行3 - 6个疗程。对于多器官囊性包虫病（CE）和泡型包虫病（AE）患者，给予12 - 18个疗程的阿苯达唑治疗。患者分为4组：（i）ABZ手术组，21例CE患者接受阿苯达唑联合手术治疗；（ii）非ABZ手术组，80例CE患者仅接受手术治疗；（iii）ABZ CE组，58例CE患者仅接受阿苯达唑治疗，以及（iv）ABZ AE组，14例AE患者接受阿苯达唑和手术干预治疗，5例AE患者仅接受阿苯达唑治疗。与（ii）组相比，（i）组34个囊肿中有27个（79.4%）显示坏死变化增加且囊肿活力降低。然而，（ii）组84个囊肿中有10个（11.9%）在手术时显示出自发坏死迹象。在（iii）组中，仅阿苯达唑治疗使14例（24.1%）患者治疗成功，29例（50%）患者病情改善，15例（25.9%）患者无效。（iv）组7例患者病情改善，病变大小缩小且无活力。（iv）组其余7例患者在手术时显示囊肿有活力；2例在接受另外15个疗程的阿苯达唑治疗后无法挽救。在（iv）组仅接受阿苯达唑治疗的5例AE患者中，1例改善，2例病情稳定，1例恶化，1例死亡。阿苯达唑化疗虽然不完全有效，但在囊性和泡型包虫病的治疗中具有重要作用。
