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苯并咪唑类药物对泡型包虫病(AE)的疗效

[Efficacy of benzimidazole-type drugs on alveolar echinococcosis (AE)].

作者信息

Sato N, Uchino J, Aoki S, Taguchi K, Nishikawa M, Baba E, Nakagawa T, Hata T, Shimamura T, Kamiyama T

机构信息

First Department of Surgery, Hokkaido University School of Medicine.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 1994 Jul;91(7):1197-204.

PMID:8065050
Abstract

AE patients can be cured only by complete excision of the lesions. In Europe and the United States, however, benzimidazole-type drugs have been reported to be effective. We treated 37 patients (20 males and 17 females, mean age of 45.9 years) with mebendazole (MBZ) (n = 17) or albendazole (ABZ) (n = 20) according to the WHO chemotherapy protocol, and compared adverse reactions, drug concentrations, serological parameters, and measurable lesions by CT scan and/or X-ray examination. In the MBZ group, serological parameters were unaffected. One patient each had hepatic disorder and alopecia (12%), and 5 lesions in the liver and 3 in the lung gradually increased in size (105% in 1 year, 112% in 2 years), and showed NC (no response) in 6, PD (progressive disease) in 2. One case of released biliary obstruction were judged as PR (partial response) (Response rate: 11.1%). In the ABZ group, no adverse reactions were found and ELISA level decreased significantly in 10 out of 12 patients. One lesion in the liver, 3 in the lung, 1 in the chest wall and 1 in the retropancreatic region reduced in size significantly (Mean: 56%) (PR 3, NC 3; Response rate: 50.0%). ABZ was safer and more effective than MBZ.

摘要

AE患者只有通过彻底切除病灶才能治愈。然而,在欧洲和美国,有报道称苯并咪唑类药物有效。我们根据世界卫生组织的化疗方案,用甲苯达唑(MBZ)(n = 17)或阿苯达唑(ABZ)(n = 20)治疗了37例患者(20例男性和17例女性,平均年龄45.9岁),并比较了不良反应、药物浓度、血清学参数以及通过CT扫描和/或X线检查测得的病灶情况。在MBZ组中,血清学参数未受影响。各有1例患者出现肝脏疾病和脱发(12%),肝脏有5个病灶,肺部有3个病灶,其大小逐渐增大(1年内增大105%,2年内增大112%),6例显示无反应(NC),2例显示疾病进展(PD)。1例解除胆道梗阻的患者被判定为部分缓解(PR)(缓解率:11.1%)。在ABZ组中,未发现不良反应,12例患者中有10例ELISA水平显著下降。肝脏有1个病灶,肺部有3个病灶,胸壁有1个病灶,胰后区域有1个病灶,其大小显著缩小(平均:56%)(PR 3例,NC 3例;缓解率:50.0%)。ABZ比MBZ更安全、更有效。

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