棘球蚴病的内科治疗进展  

Progress in medical treatment of echinococcosis

作　　者：何达[1] 吴建利 吕晓菊[1] HE Da;WU Jianli;LÜXiaoju(Center of Infectious Diseases,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;Department of Cardiology,The First People’s Hospital of Shuangliu District(West China Airport Hospital of Sichuan University),Chengdu 610200,P.R.China)

机构地区：[1]四川大学华西医院感染性疾病中心,成都610041 [2]成都市双流区第一人民医院-四川大学华西空港医院心血管病区,成都610200

出　　处：《中国普外基础与临床杂志》2024年第10期1188-1192,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：棘球蚴病(也称“包虫病”)是严重威胁人类健康的一种人畜共患疾病。该病在我国分布范围广,在西藏自治区、青海省、新疆维吾尔自治区、四川省等地都有分布,增加了我国社会经济负担。人类主要感染泡型和囊型棘球蚴病,主要累及肝、肺、脑、骨等器官组织。首选外科手术切除,内科药物治疗也是重要治疗方式,当前经典的药物主要是阿苯达唑及吡喹酮单独或联合应用,现也已有一些包括广谱抗感染药物如硝唑尼特等、抑制细胞增殖药物如硼替佐米等、代谢药物如二甲双胍等或传统医药如青蒿素等尝试用于治疗棘球蚴病。还提出了对棘球蚴病建议采用癌症管理模式,并且经抗虫治疗后的囊型棘球蚴病影像学随访时间至少需超过3年、泡型棘球蚴病至少需超过10年,更重要的是采取宣教、疫苗接种等措施,积极预防和控制棘球蚴病,以有效降低棘球蚴病的发生率与减少传播。Echinococcosis is a zoonotic disease that seriously threatened human health.The disease is widely distributed in China,including in Tibet Autonomous Region,Qinghai Province,Xinjiang Uygur Autonomous Region,Sichuan Province,and other places,which has become a social and economic burden in China.Human beings are mainly infected with alveolar echinococcosis(AE)and cystic echinococcosis(CE),which mainly involves liver,lung,brain,bone,and other organs or tissues.The surgical resection is the first line treatment,and antiparasitic agents therapy is the main supplementary or salvage treatment method.Currently,classic drugs mainly include albendazole and praziquantel,which use alone or in combination.There are also some attempts to treat echinococcosis,including broad-spectrum anti infective drugs such as nitrozotocin,cell proliferation inhibiting drugs such as bortezomib,metabolic drugs such as metformin,or traditional medicines such as Artemisinin.It was also suggested to adopt a cancer management model for echinococcosis,and the imaging follow-up time for CE after antiparasitic chemotherapy should be at least 3 years,and for AE should be at least 10 years.More importantly,measures such as education and vaccine inoculation should be taken to actively prevent and control the occurrence and spread of echinococcosis.

关 键 词：棘球蚴病 包虫病 囊型棘球蚴病 泡型棘球蚴病 阿苯达唑 吡喹酮 抗虫化疗 

分 类 号：R532.32[医药卫生—内科学]