Ammann R W, Fleiner-Hoffmann A, Grimm F, Eckert J
Department of Medicine, University Hospital, University of Zurich, Switzerland.
J Hepatol. 1998 Dec;29(6):994-8. doi: 10.1016/s0168-8278(98)80129-3.
Long-term chemotherapy of human alveolar echinococcosis with benzimidazole compounds (mebendazole, albendazole) has been shown to be primarily parasitostatic, but its curative (parasitocidal) efficacy is debated. This article reports on a 67-year-old male patient with non-resectable alveolar echinococcosis of the liver who had been continuously treated for 13 years with mebendazole (approximately 45-48 mg/kg body weight per day) and who was closely monitored according to a specific protocol. At the age of 80 years the patient died of oesophageal variceal bleeding. During treatment the hepatic lesion had decreased markedly in size in association with progression of perifocal calcification. At autopsy, a well-demarcated, necrotic, partially calcified, parasite-induced lesion of the right liver lobe and secondary biliary cirrhosis were found. Remnants of parasite tissue obtained from the periphery of the lesion showed a small-cystic structure, but it was not viable, as evidenced by transplantation of tissue blocks to rodents. The case is suggestive for a parasitocidal efficacy of mebendazole treatment carried out for 13 years, and is discussed in context with conflicting literature data.
长期使用苯并咪唑类化合物（甲苯达唑、阿苯达唑）对人类肺泡型棘球蚴病进行化疗已被证明主要具有抑制寄生虫的作用，但其治疗（杀灭寄生虫）效果仍存在争议。本文报道了一名67岁男性患者，患有不可切除的肝肺泡型棘球蚴病，他接受甲苯达唑（约每日45 - 48毫克/千克体重）连续治疗13年，并根据特定方案进行密切监测。患者80岁时死于食管静脉曲张出血。治疗期间，肝脏病变大小明显减小，同时病灶周围钙化进展。尸检时，发现右肝叶有一个界限清楚、坏死、部分钙化、由寄生虫引起的病变以及继发性胆汁性肝硬化。从病变周边获取的寄生虫组织残余显示为小囊状结构，但无活力，将组织块移植到啮齿动物身上可证明这一点。该病例提示甲苯达唑治疗13年具有杀灭寄生虫的效果，并结合相互矛盾的文献数据进行了讨论。
