Michalová K, Ríhová E, Havlíková M
I. ocní klinika 1. LF UK, Praha.
Cesk Slov Oftalmol. 1996 Jul;52(3):173-8.
Toxoplasmosis chorioretinitis is the most frequent posterior uveitis. Different treatment modes are used for its therapy. Classical is the combination of 50 mg of pyrimethamine with 4 g of sulphadiazine and corticosteroids. In this study the results of treatment with lower doses of pyrimethamine together with long-acting sulphonamide are reported. Twelve patients were treated with Fansidar, combination of 25 mg of pyrimethamine and 500 mg sulphadoxine. The treatment consisted of a loading dose of two tablets of Fansidar, followed by one tablet a day. Prednisone 0.5 mg/kg/day was added and gradually tapered off. Patients were treated for 28 days on average (range 21-50 days). In 83% of patients the scar was considerably smaller than original lesion (on average the scar represented 25% of original lesion). Three months after the treatment the visual acuity was 6/9 or better in 83% of patients. No side-effects of the treatment were observed. Lower doses of pyrimethamine with suphadoxine in an easy once a day treatment regime could be an alternative and cost-effective therapy for ocular toxoplasmosis.
弓形虫性脉络膜视网膜炎是最常见的后葡萄膜炎。其治疗采用不同的治疗方式。经典的治疗方法是将50毫克乙胺嘧啶与4克磺胺嘧啶及皮质类固醇联合使用。本研究报告了低剂量乙胺嘧啶与长效磺胺联合治疗的结果。12例患者接受了 Fansidar（25毫克乙胺嘧啶与500毫克周效磺胺的组合）治疗。治疗开始时服用两片 Fansidar作为负荷剂量，之后每天服用一片。加用泼尼松0.5毫克/千克/天，并逐渐减量。患者平均治疗28天（范围为21 - 50天）。83%的患者瘢痕明显小于原病变（平均瘢痕面积占原病变的25%）。治疗三个月后，83%的患者视力达到6/9或更好。未观察到治疗的副作用。低剂量乙胺嘧啶与周效磺胺，采用简便的每日一次治疗方案，可能是眼部弓形虫病的一种替代且经济有效的治疗方法。
