云南省恶性疟原虫对氯喹抗性的变化  

THE CHANGE OF PLASMODIUM FALCIPARUM RESISTANCE TO CHLOROQUINE IN YUNNAN PROVINCE, CHINA

作　　者：杨恒林[1] 杨品芳[1] 李兴亮[1] 高白荷[1] 张志勇[1] 杨亚明[1] 

机构地区：[1]云南省疟疾防治研究所,云南思茅665000

出　　处：《中国寄生虫病防治杂志》2005年第5期368-370,共3页Chinese Journal of Parasitic Disease Control

基　　金：联合国发展规划署/世界银行/世界卫生组织热带病研究培训特别计划处(TDR;900098);世界卫生组西太区办事处(WPR02048)资助项目。~~

摘　　要：目的了解云南恶性疟原虫对氯喹抗性的变化. 方法从1981年起,在滇西、滇南、滇东南监测点选择符合条件的恶性疟病人,取静脉血,采用WHO推荐的体外微量法测定恶性疟原虫对氯喹的敏感性,并将相隔8～10年的测定结果进行比较. 结果滇西恶性疟原虫对氯喹抗性率从1982年的100%下降到2003年的83.3%,ID50 从240.0 nmol/L降到123.0 nmol/L,MIC从1 171.6 nmol/L降至325.9 nmol/L,分别下降13.0%、48.8%和72.2%.滇南恶性疟原虫对氯喹抗性率从1981年的97.4%降到2004年的69.0%,ID50从170.0 nmol/L降至58.6 nmol/L,MIC从1 108.0 nmol/L降至312.6 nmol/L,分别下降29.1%、65.5%和71.8%;滇东南抗性率从1993年的78.9%下降至2003年的53.3%,ID50从136.0 nmol/L降至75.5 nmol/L,MIC从452.0 nmol/L 降至238.3 nmol/L,分别下降32.4%、44.5%和47.3%. 结论云南恶性疟原虫对氯喹仍具有抗性,但抗性程度明显下降;中越边境恶性疟的抗性程度低于中老、中缅边境地区.目前仍不宜用氯喹治疗当地恶性疟.Objective To determine the change of Plasmodium falciparum resistance to chloroquine in Yunnan Province of China. Methods Since 1981, the falciparum malaria cases from three tested areas, Western Yunnan, Southern Yunnan and East-southern Yunnan, were selected as observation objects, vein blood was collected and P. falciparum resistance to chloroquine was assayed using Reikmann＇s in vitro recommended by WHO, and the results of 8--10 years longitudinal surveillance were compared in. Results In Western Yunnan （China-Myanmar border areas）, the resistant rate dropped from 100% in 1982 to 83.3% in 2003, ID50 declined from 240.0 nmol/L to 123. 0 nmol/L, the mean concentration for complete inhibition of sehizont formation （MIC） from 1 171.6 nmol/L to 325.9 nmol/L, they were dropped 48.8% and 72.2%, respectively. In Southern Yunnan （China-Laos and China-Myanmar border areas）, the resistant rate declined from 97.4% in 1981 to 69.0% in 2004, ID50 dropped from 170.0 nmol/L to 58.6 nmol/L, MIC from 1 108,0 nmol/L to 312.6 nmol/L, were declined 65.5% and 71.8%, respectively. In East-Southern Yunnan （China-Vietnam border areas）, the resistant rate dropped from 78.9% in 1993 to 53.3% in 2003; ID50,MIC declined from 136.0 nmol/L and 425.0 nmol/L to 75.5 nmol/L and 238.3 nmol/L, they were dropped 44.5% and 47.3 %, respectively. Conclusion P. falciparurn is still resistant to ehloroquine, but the resistant degree had markedly dropped in Yunnan Province. The resistant degree of P. falciparurn in China-Vietnam border areas is lower than that in China-Laos and China-Myanmar border areas. It is inadvisable that ehloroquine is used to treat faleiparum malaria cases in the areas.

关 键 词：云南省 疟原虫 恶性 氯喹抗性 纵向监测 

分 类 号：R382.31[医药卫生—医学寄生虫学]