阿苯达唑、吡喹酮联合应用治疗脑囊虫病临床研究  

Clinical observation on the effect of combined use of praziquantel and albendazole on cerebral cysticercosis.

作　　者：王忠磊[1] 寇景轩[1] 胡颖新[1] 刘玉磊[1] 毛德华[1] 陈红旗[1] 

机构地区：[1]山东省寄生虫病防治研究所,山东济宁272033

出　　处：《中国热带医学》2008年第11期1873-1876,共4页China Tropical Medicine

摘　　要：目的研究阿苯达唑、吡喹酮联合应用治疗脑囊虫病的临床疗效及影像学、免疫学、脑电图的变化。方法对2 539例脑囊虫病患者应用阿苯达唑、吡喹酮联合抗囊治疗后临床、影像学、免疫学及脑电图资料进行系统性回顾研究。结果2 539例脑囊虫病患者经3～4个疗程的抗囊治疗后,临床上有94.53%(1 349/1 427)患者癫痫发作症状得到完全控制,96.31%(861/894)患者头痛、头晕、恶心、呕吐症状消失;93.31%(223/239)记忆力减退的患者恢复到病前水平,其他如肢体麻木、语言障碍、视乳头水肿及皮下结节等症状全部消失;复查脑CT或MR I,有82.95%(2 106/2 539)脑囊虫病患者低密度灶全部吸收、17.05%(433/2 539)患者病灶大部分吸收,小部分转化为钙化灶;987例患者观察了免疫学的动态变化,血IHA、ELISA、CAg阳性率分别为74.77%(738/987)、84.70%(836/987)、3.75%(37/987);复查脑电图1 253例,其中恢复正常和明显好转的为74.86%(938/1253)、20.03%(251/1 253);所有患者治疗前后对比除IHA、ELISA结果无统计学意义外均具有显著性差异(P<0.01);临床治愈率82.95%(2 106/2 539),显效率17.05%(433/2 539),总有效率100%。结论阿苯达唑、吡喹酮联合应用治疗脑囊虫病可显著提高治愈率。影像学、免疫学及脑电图检查从不同方面对脑囊虫病的诊断、疗效考核具有重要的使用价值。Objective To observe the clinical efficacy, imaging, immunology and EEG changes in cerebral cysticercosis patients treated with praziquantel and albendazole. Methods The data of clinical features,imaging,immunology and EES of 2539 cerebral cysticercosis patients before and after treatment were retrospectively analyzed. Results After 3 - 4 courses of treatment, 94.53 % （ 1349/1427 ） of epileptic seizure was controlled, 96.31% （861/894） of the symptoms of headache, dizziness nausea,vomiting disappeared and 93.31% （223/239） of those lost their memory recovered. The symptoms of limb numbness,language barriers,papilledema and subcutaneons nodules also disappeared . CT or Mill show that the low density foci were all absorbed in 82.95% （2106/2539） or calcified in 17.05% （433/2539） of the patiens . The positives rates of blood IHA ,ELISA and Cag were 74.77% （738/987） ,84.70% （836/987） and 3.75% （57/987） respectively. The normal and improved EEGs were observed in 74.86% （938/1253） and 20.03% （251/1253） . There were singificant differences in cure rate, effectvie rate amd total effective rate before and after treatment, being 82.95% （2106/2539） and 17.05% （435/ 2539） respectively, excluded IHA , ELISA （ p 〈 0.01 ）. Conclusion Combined use of albendazole and praziquantel can improve the effective rate obviously. Imaging,immunology and EEG check are valuable for diagnosis and the trentment of patients with cerebral cysticercosis .

关 键 词：脑囊虫病 吡喹酮 阿苯达唑 临床 影像学 免疫学 脑电图 

分 类 号：R532.38[医药卫生—内科学]