Hoontrakoon S, Suputtamongkol Y
Department of Medicine, Chumphorn Hospital, Thailand.
Trop Med Int Health. 1998 Feb;3(2):156-61. doi: 10.1111/j.1365-3156.1998.00198.x.
To compare the efficacy of exchange transfusion as the adjunct to quinine treatment (21 patients) with quinine therapy alone (29 patients).
A retrospective study of 50 patients with severe falciparum malaria was conducted at Chumphorn Hospital, Southern Thailand.
Clinical characteristics in both treatment groups were not significantly different although in the exchange transfusion group, the admission geometric mean parasitaemia (18 (5%), and the proportion of patients with more than 10% parasitaemia was higher (76%, P = 0.03) than in the group who received quinine alone (10 +/- 4%; 38%, P = 0.1). The mortality rate of patients who received exchange transfusion was 48%; that of the remainder, 69%. (P = 0.3). ARDS (P = 0.01) and oliguric renal failure (P = 0.04) were significant risk factors for death in these patients.
Exchange transfusion was safe and well tolerated. Results of our study revealed a 20% reduction in mortality when exchange transfusion was used as an adjunct to quinine treatment. It should therefore be considered in patients with severe falciparum malaria when possible.
比较换血疗法作为奎宁治疗辅助手段（21例患者）与单纯奎宁治疗（29例患者）的疗效。
对泰国南部春蓬医院50例重症恶性疟患者进行回顾性研究。
尽管换血治疗组入院时疟原虫血症几何均数（18（5%））以及疟原虫血症超过10%的患者比例（76%，P = 0.03）高于单纯接受奎宁治疗的组（10 +/- 4%；38%，P = 0.1），但两个治疗组的临床特征无显著差异。接受换血治疗患者的死亡率为48%；其余患者的死亡率为69%。（P = 0.3）。急性呼吸窘迫综合征（P = 0.01）和少尿性肾衰竭（P = 0.04）是这些患者死亡的显著危险因素。
换血疗法安全且耐受性良好。我们的研究结果显示，换血疗法作为奎宁治疗的辅助手段时，死亡率降低了20%。因此，对于重症恶性疟患者，应尽可能考虑采用该疗法。
