在巴西里约热内卢（利什曼原虫（V.）巴西亚种传播地区）采用五价锑对美洲皮肤利什曼病进行病灶内治疗。
Intralesional therapy of American cutaneous leishmaniasis with pentavalent antimony in Rio de Janeiro, Brazil--an area of Leishmania (V.) braziliensis transmission.
作者信息
Oliveira-Neto M P, Schubach A, Mattos M, da Costa S C, Pirmez C
机构信息
Hospital Evandro Chagas, Fundação Oswaldo Cruz, Brazil.
出版信息
Int J Dermatol. 1997 Jun;36(6):463-8. doi: 10.1046/j.1365-4362.1997.00188.x.
BACKGROUND
The drug of choice for leishmaniasis is pentavalent antimony and different regimens are under continuous evaluation. The ideal therapy should be simple, effective, and with no or minor side-effects. In this paper we have studied the efficacy of intralesionally applied antimony in New World cutaneous leishmaniasis.
METHODS
Seventy-four patients from Rio de Janeiro state, Brazil, and presenting with single ulcerative cutaneous lesions mainly located on the trunk or extremities were enrolled in the study. The drug employed was N-methyl glucamine (425 mg of Sbv in each 5 ml ampoule). Each lesion was infiltrated with the drug at the four cardinal points in order to achieve complete blanching.
RESULTS
Of the 74 patients, 59 (80%) were healed after a 12-week interval. Extensive follow-up (up to 10 years) disclosed no relapses or the development of mucosal lesions.
CONCLUSIONS
The aim of therapy in New World cutaneous leishmaniasis is the healing of the cutaneous lesion and the prevention of late mucosal damage. Both conditions were achieved with the treatment employed with no side-effects and a considerable decrease in costs. In addition, the method is easy to apply in the field.
背景
利什曼病的首选药物是五价锑，不同的治疗方案一直在持续评估中。理想的治疗方法应该简单、有效，且无或仅有轻微副作用。在本文中，我们研究了皮损内注射锑剂治疗新大陆皮肤利什曼病的疗效。
方法
来自巴西里约热内卢州的74例患者参与了本研究，这些患者主要表现为位于躯干或四肢的单个溃疡性皮肤损害。使用的药物是N-甲基葡糖胺（每5毫升安瓿含425毫克五价锑）。在每个损害的四个基点处注射药物，以实现完全变白。
结果
74例患者中，59例（80%）在12周后治愈。广泛随访（长达10年）未发现复发或黏膜损害的发生。
结论
新大陆皮肤利什曼病的治疗目标是治愈皮肤损害并预防晚期黏膜损伤。采用的治疗方法实现了这两个目标，且无副作用，成本大幅降低。此外，该方法易于在现场应用。
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