我国恶性疟原虫对青蒿素类药物的敏感性监测  

Monitoring of the sensitivity of Plasmodium falciparumto artemisinin-based drugs in China

作　　者：冯晓平[1] 杨恒林[2] 王善青[3] 杨品芳[2] 林世干[3] 刘德全[1] 夏志贵[1] 

机构地区：[1]中国疾病预防控制中心寄生虫病预防控制所,卫生部寄生虫病原与媒介生物学重点实验室,世界卫生组织疟疾、血吸虫病和丝虫病合作中心,上海200025 [2]云南省寄生虫病防治所,云南普洱665000 [3]海南省疾病预防控制中心,海南海口570203

出　　处：《中国病原生物学杂志》2016年第1期30-33,共4页Journal of Pathogen Biology

基　　金：世界卫生组织热带病研究和培训特别规划署項目(WHO/TDR 900098);世界卫生组织西太区办事处项目(ID MVP/CHN/02/01)

摘　　要：目的监测恶性疟原虫对青蒿素类药物的敏感性,为合理使用抗疟药提供参考。方法在研制成功涂药板和便于现场使用的培养基后,采用世界卫生组织(WHO)推荐的体外微量法,开展了恶性疟原虫对青蒿琥酯、双氢青蒿素、蒿甲醚及蒿乙醚等药物的敏感性监测。结果海南省乐东县监测的完全抑制疟原虫裂殖体形成的平均药浓度,1986年为0.028pmol/μl,2002年上升至0.135pmol/μl(P<0.01);≥4pmol/μl完全抑制裂殖体形成例数所占百分比,由1986年的5.5%上升至2002年为21.8%(0.025<P<0.01)。云南省勐腊县、中-缅边境和中-老边境地区测得的完全抑制疟原虫裂殖体形成的平均药浓度,分别为6.8nmol/L^11.1nmol/L、32nmol/L和46nmol/L;≥4pmol/μl完全抑制裂殖体形成例数所占百分比,分别为4.5%、16.7%和12.1%。结论海南省和云南省的中-缅边境和中-老边境地区恶性疟原虫对青蒿素类药物的敏感性在逐渐下降。Objective To monitor the sensitivity of Plasmodium falciparumto artemisinin derivatives in order to allow rational use of antimalarials. Methods Microplates and medium for field used were successfully prepared and then an in vitro micro assay recommended by the WHO was used to ascertain the sensitivity of P.falciparumto artesunate,dihydroartemisinin,artemether,and arteether. Results In Ledong County,Hainan Province,the mean concentration of artesunate for complete inhibition of schizont formation increased from 0.028pmol/μl in 1986 to 0.135pmol/μl in 2002（P〈0.01）,and the proportion of samples without schizont formation in the presence of≥4pmol/μl of artesunate increased from 5.5%in 1986 to 21.8%in 2002（0.025〈P〈0.01）.The mean concentration of artesunate for complete inhibition of schizont formation was 6.8nmol/L-11.1nmol/L in Mengla County,32nmol/L on the China-Myanmar border,and 46nmol/L on the China-Laos border of Yunnan Province.The proportion of samples with complete inhibition of schizont formation in the presence of≥4pmol/μl of artesunate was 4.5%in Mengla County,16.7% on the China-Myanmar border,and 12.1% on the China-Laos border of Yunnan Province. Conclusion The sensitivity of P.falciparum to artemisinin-based drugs has gradually decreased in Hainan Province,on the China-Myanmar border,and on the ChinaLaos border of Yunnan Province.

关 键 词：青蒿素 敏感性 体外微量法 监测 恶性疟原虫 

分 类 号：R382.31[医药卫生—医学寄生虫学]