缅甸拉咱市恶性疟原虫对6种抗疟药的敏感性体外测定  

In vitro sensitivity of Plasmodium falciparumto 6 antimalarials in the City of Laiza,Burma

作　　者：孙晓东[1] 王剑[1] 李先亮[1] 杨捷[2] 邓艳[1] Lasi Ja-hkawn 

机构地区：[1]云南省寄生虫病防治所,云南普洱665000 [2]德宏州疾病预防控制中心,云南潞西678499 [3]英国无国界卫生组织德宏项目组,云南潞西678400

出　　处：《中国病原生物学杂志》2014年第6期561-563,共3页Journal of Pathogen Biology

摘　　要：目的了解中缅边境缅甸拉咱市恶性疟药物抗性现状,为中国第六轮全球基金疟疾项目制定防治策略提供依据。方法在缅甸拉咱市城区建立研究站,镜检发热病人和/或疑似疟疾病例,筛查疟疾患者。选择城区及郊区4村的单纯恶性疟现症患者,用WHO推荐的体外微量试验测定恶性疟原虫对6种抗疟药的敏感性。结果体外微量测定43例,成功27例,测得恶性疟原虫对氯喹、哌喹、咯萘啶、青蒿琥酯、双氢青蒿素和双氢青蒿素/哌喹的抗性率分别为100%、0、25.9%、22.2%、7.4%和0,半数抑制浓度(IC50)分别为298.0、49.4、22.3、24.3、11.8和5.6/44.8nmol/L。结论缅甸拉咱市流行株恶性疟原虫对氯喹100%抗性,对咯萘啶、青蒿琥酯和双氢青蒿素具有一定程度抗性,对氯喹、咯萘啶和青蒿琥酯抗性呈逐渐增强趋势,对哌喹和双氢青蒿素/哌喹敏感。Objective To ascertain the status of Plasrnodium falciparurn resistance to antimalarials in the City of Laiza, Burma near the border with China in order to provide data to formulate a control strategy for the sixth round of Chinese projects supported by the Gqobal Fund to Fight HIV/AIDS, Tuberculosis, and Malaria. Methods A research station was set up in downtown Laiza. Individuals with a fever and/or malaria were screened for malaria using microscopy. Patients infected with P. falciparurn who are living downtown or in four suburban natural villages of the City of Laiza were selected for this study. An in vitro micro-test as recommended by the WHO was performed to determine the susceptibility of P. falciparurn to 6 antimalarials. Results The in vitro micro-test identified 43 patients, 27 of whom responded to treatment. P. falciparum was resistant to chloroquine at a rate of 100%, to piperaquine at a rate of 0%, to py ronaridine at a rate of 25.9%, to artesunate at a rate of 22.2%, to dihydroartemisinin at a rate of 7.40/oo, and to dihydroartemisinin/piperaquine at a rate of 0 %. The 50 % inhibitory concentration （IC50） of chloroquine was 298.0, that of piperaquine was 49.4, that of pyronaridine was 22.3, that of artesunate was 24.3, that of dihydroartemisinin was 11.8, and that of dihydroartemisinin/piperaquine was 5.6/44.8 nmol/L. Conclusion P. falciparum in the City of Laiza, Burma has 100% resistance to chloroquine. P. falciparurn has a certain level of resistance to pyronaridine, artesunate, and dihydroartemisinin. The degree of its resistance to chloroquine, pyronaridine, and artesunate is gradually increasing, but P. falciparum is still susceptible to piperaquine and dihydroartemisinin/piperaquine.

关 键 词：缅甸 疟原虫 恶性 体外微量试验 敏感性 抗性 

分 类 号：R382.31[医药卫生—医学寄生虫学]