蒿甲醚联合伯氨喹治疗恶性疟疾  

Clinical Analysis of 87 Cases with Falciparum Malaria

作　　者：李津[1] 肖海[1] 王万明[1] 马卫闽[1] 饶本强[1] 

机构地区：[1]南京军区福州总医院,福建福州350025

出　　处：《中国临床医学》2007年第5期736-737,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨恶性疟疾的临床特征以提高其临床诊治水平。方法:回顾分析在西非维和任务区2004年4月—2004年12月间收治恶性疟疾87例的临床资料,患者随机分成两组,联合组46例,肌注蒿甲醚80mg,qd×7d,首剂加倍,加服伯氨喹22.5mg,qd×8d;对照组41例,单用肌注蒿甲醚治疗,所用剂量和疗程同联合组。观察和记录各例的临床症状和药物的不良反应。结果:临床表现主要为发热,畏寒,头痛,全身肌肉、关节酸痛,疲乏。联合组和对照组病例的临床治愈率为100%和95.1%;平均退热时间为(43.7±10.3)h和(45.6±14.7)h;平均疟原虫转阴时间为(29.3±8.9)h和(31.6±9.7)h;复燃率为6.5%和29.3%。结论:早期诊断,及时、合理的处理是治疗恶性疟疾的关键。蒿甲醚对恶性疟疾有显著的临床疗效,不良反应小。联合治疗组复燃率明显低于对照组。Objective： To explore the clinical characteristics of falciparum malaria and to facilitate its earlier diagnosis and treatment. Methods：Eighty seven cases of falciparum malaria between Apr. 2004 and Dec. 2004 in the area of UN peacekeeping in West Africa were reviewed. Randomization and comparison methods were used in 87 falciparum malaria cases, Among them 46 cases were treated with artemether （80 mg,intramuscularly, qd × 7 d） combined with primaquine （22.5 mg orally 50 rag, qd ×8 d）, 41 cases received single artemether were taken as control. All of them had follow-up after treatment. The clinical symptoms and the side effects of drugs were observed. Results：The clinical manifestation mostly were fever, chill, headache, aching pain in muscle and joints, fatigue. In combined group and control group, clinical cure rates were 100% and 95.1%, the mean fever clearance time were 43.7 ± 10.3 hours and 45.6 ± 14.7 hours, with an average parasite clearance time of 29.3 ± 8.9 hours and 31.6± 9.7 hours, relapse rates 6.5% and 29.3 % respectively. Conclusion： The key procedures for treating falciparum malaria are earlier diagnosis and effective therapy. Artemether shows high efficacy in falciparum malaria cases and low side effects. Combined methods are more effective in reducing relapse rate of malaria.

关 键 词：恶性疟疾 诊断 治疗 

分 类 号：R531.3[医药卫生—内科学]