氯喹和伯氨喹治疗缅甸拉咱地区间日疟的效果评价  

Evaluation of vivax malaria treatment in China-Myanmar border areas

作　　者：梁桂亮 张再兴[2] 孙晓东[2] 王剑[2] 

机构地区：[1]昆明市第三人民医院检验科,云南昆明650000 [2]云南省寄生虫病防治所,云南省疟疾防治中心,云南普洱665000

出　　处：《中国病原生物学杂志》2010年第9期672-675,共4页Journal of Pathogen Biology

基　　金：第五轮中国全球基金疟疾项目硕士研究生培养专项基金项目(No.2007-03)

摘　　要：目的了解氯喹加伯氨喹治疗缅甸拉咱地区间日疟的效果。方法按随机数字表将入选的病人随机分成两组（A组和B组）。A组采用氯、伯氨喹8 d疗法治疗,即成人给予氯喹口服总剂量1 200 mg和伯氨喹口服总剂量180mg;B组采用氯、伯氨喹14 d疗法治疗,即成人给予氯喹口服总剂量1 500 mg或25 mg（基质）/kg体重、伯氨喹口服总剂量210 mg[或0.25 mg（基质）/kg体重]。观察D0（服药后第1 d,之后类推）、D1、D2、D3、D7、D14、D21、D28,及2~6个月的临床疗效和复发情况。结果纳入的129例间日疟患者,111例完成D28随访观察。A、B两组原虫无性体平均转阴时间为（41.05±14.01）h和（35.93±12.62）h,差异有统计学意义（t=2.02,P〈0.05）;两组平均退热时间为（26.29±10.72）h和（23.46±11.40）h,差异无统计学意义（t=1.454,P〉0.05）。A组与B组D1、D2、D3较D0无性体密度下降率分别为92.80%、99.90%、100.0%和94.18%、99.50%、100%。B组在D14随访复查1例原虫复现。A组随访复发率为3.51%（2/57）,B组为90.26%（5/54）,差异无统计学意义（χ2=0.607,P〉0.05）。结论氯喹加伯氨喹两种疗法对缅甸拉咱地区间日疟患者预防复发的效果相同;对该地区的现症间日疟患者采用上述两种疗法治疗效果良好。Objective To ascertain the efficacy of chloroquine plus primaquine for clinical treatment and prevention of the relapse of vivax malaria in areas of the China-Myanmar border.Methods Patients were divided into groups A and B for observation using random numbers from a random number table.Patients in group A were administered an 8-day regimen of chloroquine and primaquine;adults（60 kg） were given a total chloroquine dose of 1 200 mg and primaquine dose of 180 mg.Patients in group B were administered a 14-day regimen of chloroquine and primaquine;adults were given a total chloroquine dose of 1 500 mg（or 25 mg/kg body weight（base）） and primaquine dose of 210 mg [0.25 mg/kg（base）].The clinical effects and relapse of two groups were observed on D0,D1,D2,D3,D7,D14,D21,and D28 and at M6.Results There were 129 patients in the study;of these,111 were successfully clinically observed for 28 days.The mean asexual parasite clearance time for patients in groups A and B was（41.05±14.01） h and（35.93±12.62） h,respectively;the difference in the two was statistically significant（t=2.02,P0.05）.The mean fever clearance time was（26.29±10.72） h and（23.46±11.40） h,respectively,and the difference was not statistically significant（t=1.454,P0.05）.Compared to D0,the rate of reduced asexual parasite density on D1,D2,and D3 was 92.80%,99.90%,and 100% for group A and 94.18%,99.50%,100% for group B.One patient in group B did develop parasitemia on D14 during follow-up.There were 1,0,0,1,and 0 instances of short-term relapse during follow up at 2 months,3 months,4 months,5 months,and 6 months for Group A and 0,0,3,2,and 0 for group B.The short-term relapse rates for the two groups did not differ statistically（χ2=0.607,P0.05）.Conclusion The 8-day and 14-day regimens had the same effect on preventing relapse.Both methods had therapeutic efficacy in treating patients with vivax malaria in Laza,Myanmar.

关 键 词：间日疟 氯喹 伯氨喹 复发 缅甸 

分 类 号：R531.3[医药卫生—内科学]