蒿甲醚、青蒿琥酯等抗疟药治疗输入性恶性疟临床观察  

Clinical Observation of Antimalarial Drugs for Imported Cases of Plasmodium Falciparum

作　　者：王忠磊[1] 胡颖新[1] 付婷霞[1] 毛德华[1] 马巧荣[1] 付斌[1] 刘新[1] 

机构地区：[1]山东省医学科学院,山东省寄生虫病防治研究所,山东济宁272033

出　　处：《寄生虫病与感染性疾病》2016年第3期129-132,共4页Parasitoses and Infectious Diseases

基　　金：中国全球基金疟疾项目实施性研究专项(No.201201055)

摘　　要：目的探讨蒿甲醚、青蒿琥酯等抗疟药治疗输入性恶性疟的临床特征及治疗效果。方法对226例输入性恶性疟患者应用蒿甲醚、青蒿琥酯抗疟治疗前后的临床资料进行回顾性分析。结果患者主要临床表现为发热226例(100%)、头痛149例(65.93%)、畏寒91例(40.26%)、乏力97例(42.92%)、肌肉酸痛76例(33.62%)、腹泻32例(14.16%)等多种症状;实验室检查:贫血105例(46.46%)血小板减少82例(36.28%)、白细胞增高54例(23.98%)、转氨酶增高172例(76.11%)、蛋白尿68例(30.09%)等;超声示肝脾肿大174例(76.99%);胸透示气管炎58例(25.66%)。经蒿甲醚、青蒿琥酯等综合治疗,临床治愈率为99.12%%。患者抗疟治疗后体温在24 h^72 h内恢复正常205例(90.71%),其他症状如头痛、乏力、寒战等一般在48~96 h内消失。有73例(69.52%)贫血患者、69例(84.15%)血小板减少患者、141例(81.98%)转氨酶升高的患者抗疟治疗后恢复到正常值范围之内,其余明显改善;112例(64.37%)肝脾肿大患者基本恢复正常,54例白细胞增高及68例蛋白尿患者全部转为正常范围。结论输入性恶性疟临床表现复杂多样、并发症多、早期诊断、及时合理的处理是治疗输入性恶性疟的关键。蒿甲醚、青蒿琥酯等抗疟药治疗输入性恶性疟具有显著的临床疗效,副作用少,作用迅速,复燃率低,是有效的首选药物。Objective To explore the effect and features for imported cases of Plasmodium falciparum （ Pf. ） of Artemether, Artesunate and other antimalarial drugs Methods Using the retrospective analysis, the clinical data of imported Pf. was analyzed to evaluated the effect of Artemether, Artesunate and other antimalarial drugs. Results The main symphonies included fever for 226 cases （100%）, headache for 149 cases （65.93%）, chills for 91 cases （40. 26% ）, fatigue for 97 cases （42.92%）, muscle aches for 76 cases （33.62%） and diarrhea for 32 cases （ 14. 16% ）. The laboratory examination showed 105 cases （46.46%） in anemia, 82 cases （36. 28% ） in thrombocytopenia, 54 cases （23.98%） in WBC increased, 172 cases （76. 11%） in transaminase increased and 68 cases （30. 66% ） in proteinuria. The ultrasonography showed 174 cases （76.99%） were hepatosplenomegaly and X - ray of chest showed 58 cases （25.66%） in tracheitis. After antimalarial and supporting treatment, the cure rate was 99.12%. 205 cases （81.98%） were temperature recovery within 24 to 72 hours after antimalarial treatment, and other symptoms such as headache, fatigue and chills disappeared within 48 to 96 hours. There were 73 cases （69.52%） of anemia, 69 cases （84. 15 % ） of thrombocytopenia and 141 cases （81.98%） of transaminase increased recovered after antima- larial treatment. There were 121 cases （64. 37% ） of hepatosplenomegaly, 54 cases of WBC increased and 68 cases of proteinuria recovered on normal. Conclusion Imported falciparum malaria was complex and diverse with various complications. The key points of imported Pf. treatment were early diagnosis and appropriate treatment. Artemether, Artesunate and other antimalarial drugs are effective primary treatment drugs for imported Pf. with fewer side effects, rapid and lower resurgence.

关 键 词：恶性疟 输入性疟疾 蒿甲醚 青蒿琥酯 

分 类 号：R531.3[医药卫生—内科学]