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克氏锥虫所致人类感染的病因学药物治疗

Etiological drug treatment of human infection by Trypanosoma cruzi.

作者信息

Levi G C, Lobo I M, Kallás E G, Amato Neto V

机构信息

Infectious Disease Service, Hospital do Servidor Público Estadual, Francisco Morato de Oliveira (São Paulo), Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 1996 Jan-Feb;38(1):35-8. doi: 10.1590/s0036-46651996000100007.

Abstract

Forty-nine American Trypanosomiasis (Chagas' disease) patients, with xenodiagnosis proven parasitemia were treated by the authors. Forty-one of these patients were given benznidazole, at dosages ranging from 5mg/kg/day to 8mg/kg/day, during a pre-established period of 60 days. In this group, 17 patients had an undetermined form of the disease, whereas 22 had cardiologic disease and 4 had digestive disease (two patients had a mixed form of the disease). Side effects were frequent, and led to the discontinuation of treatment in 17 patients. The follow-up period ranged from 1 to 20 years (mean follow-up period of 6 yrs. 7 mo). 26 (63.4%) of the patients became parasitemia-negative. The other eight patients were treated with nifurtimox, during 120 days, following a variable dose regime of 5mg/kg/day (initial dose) to 17 mg/kg/day (final dose). Six of them had severe side effects, and only one patient remained parasitemia-negative throughout the observation period (ranging from 1 to 18 years). Benznidazole proved to be better tolerated and more effective in the management of parasitemia when compared to nifurtimox, although more effective and less toxic drugs are still desirable.

摘要

49名经虫媒接种确诊患有美洲锥虫病(恰加斯病)且存在寄生虫血症的患者接受了作者的治疗。其中41名患者在预先设定的60天疗程中,接受了剂量为5毫克/千克/天至8毫克/千克/天的苯硝唑治疗。该组中,17名患者患有未确定类型的疾病,22名患有心脏疾病,4名患有消化系统疾病(2名患者为混合型疾病)。副作用很常见,导致17名患者中断治疗。随访期为1至20年(平均随访期为6年7个月)。26名(63.4%)患者的寄生虫血症转为阴性。其他8名患者接受了120天的硝呋莫司治疗,剂量从5毫克/千克/天(初始剂量)到17毫克/千克/天(最终剂量)不等。其中6名出现严重副作用,在整个观察期(1至18年)内只有1名患者的寄生虫血症转为阴性。与硝呋莫司相比,苯硝唑在治疗寄生虫血症方面耐受性更好且更有效,不过仍需要更有效且毒性更小的药物。

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