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中国-缅甸和中国-老挝边境地区恶性疟原虫对八种抗疟药的体外敏感性

In vitro sensitivity of Plasmodium falciparum to eight antimalarials in China-Myanmar and China-Lao PDR border areas.

作者信息

Yang H L, Liu D Q, Yang Y M, Huang K G, Dong Y, Yang P F, Liao M Z, Zhang C Y

机构信息

Yunnan Institute of Malaria Control, Simao, People's Republic of China.

出版信息

Southeast Asian J Trop Med Public Health. 1997 Sep;28(3):460-4.

PMID:9561592
Abstract

In 1991-1995 by using the Rieckmann in vitro micro-method, susceptibilities of Plasmodium falciparum to eight antimalarials in the China-Lao PDR and China-Myanmar border areas were tested. The resistant rates of P. falciparum to chloroquinine were 95.0%-100%; IC50 114-240nmol/l. P. falciparum resistant rates to amodiaquine resistance accounted for 83.5%-100%, IC50 52-72nmol/l. All cases were sensitive to quinine, IC50 470-608nmol/l. P. falciparum isolates from the Lao PDR frontier were highly sensitive to artesunate, dihydroartemisinin, and arteether. Resistant rates from other areas were 0-11%. P. falciparum from China-Myanmar and Lao PDR border areas were also sensitive to mefloquine, IC50 68-88nmol/l. A longitudinal survey of the sensitivity of P. falciparum in vivo on the China-Lao PDR border showed that the average defervescent time of falciparum malaria was treated by pyronaridine increased from 32.7 +/- 16.0 hours during 1984-85 to 56.2 +/- 27.4 hours in 1995; the recrudescence rate rose up from 15.2% to 37.5%. The results monitored in vitro showed that all cases assessed in 1988 for response to pyronaridine were sensitive, but 36.4% of cases had emerging resistance, IC50 increased from 13nmol/l to 40 nmol/l. The above results suggested that P. falciparum in these areas has expressed resistance to chloroquine and amodiaquine. However, the parasites are still sensitive to artemisinin, pyronaridine, mefloquine, quinine, but with a declining sensitivities.

摘要

1991 - 1995年,采用里希克曼体外微量法,检测了中国 - 老挝和中国 - 缅甸边境地区恶性疟原虫对8种抗疟药的敏感性。恶性疟原虫对氯喹的耐药率为95.0% - 100%;半数抑制浓度(IC50)为114 - 240纳摩尔/升。恶性疟原虫对阿莫地喹的耐药率为83.5% - 100%,IC50为52 - 72纳摩尔/升。所有病例对奎宁敏感,IC50为470 - 608纳摩尔/升。来自老挝边境的恶性疟原虫分离株对青蒿琥酯、双氢青蒿素和蒿乙醚高度敏感。其他地区的耐药率为0 - 11%。来自中国 - 缅甸和老挝边境地区的恶性疟原虫对甲氟喹也敏感,IC50为68 - 88纳摩尔/升。对中国 - 老挝边境地区恶性疟原虫体内敏感性的纵向调查显示,用咯萘啶治疗恶性疟的平均退热时间从1984 - 1985年的32.7±16.0小时增加到1995年的56.2±27.4小时;复发率从15.2%上升到37.5%。体外监测结果显示,1988年评估对咯萘啶有反应的所有病例均敏感,但36.4%的病例出现耐药,IC50从13纳摩尔/升增加到40纳摩尔/升。上述结果表明,这些地区的恶性疟原虫已对氯喹和阿莫地喹产生耐药性。然而,这些寄生虫对青蒿素、咯萘啶、甲氟喹、奎宁仍敏感,但敏感性在下降。

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