青蒿琥酯治疗脑型疟疾32例  

Artesunate in the Treatment of 32 Cases of Cerebral Malaria

作　　者：孙卫华[1] 

机构地区：[1]浙江省嘉兴市第一医院药剂科,314000

出　　处：《医药导报》2004年第4期227-228,共2页Herald of Medicine

摘　　要：目的 :探讨青蒿琥酯治疗脑型疟疾的临床疗效。方法 :恶性疟原虫引起的脑型疾患者 64例 ,随机分成治疗组和对照组各 3 2例 ,治疗组给予青蒿琥酯 ,首剂 2 .4mg·kg 1 ,将其溶于 5 %碳酸氢钠溶液 1mL ,加 5 %葡萄糖溶液 10mL稀释 ,缓慢静脉注射 ,12h后以 1.2mg·kg 1 同法给予 ,随后 6d每日以 1.2mg·kg 1 同法给予 ;对照组给予奎宁 ,首剂 2 0mg·kg 1 ,将其溶于 5 %的葡萄糖注射液 5 0 0mL ,静脉滴注 ,4h内输完 ,8h后 ,以 10mg·kg 1 维持剂量同法给予 ,随后每 8h给予 10mg·kg 1 ,直至患者能口服 ,改口服奎宁片 10mg·kg 1 ,q 8h ,直至完成 7d的疗程。结果 :治疗组起效快 ,能迅速地控制疟疾症状 ,7d治愈率治疗组 90 .6% ,对照组 87.5 % ,差异无显著性 (P >0 .0 5 ) ;两组的退热时间分别为 2 4和 48h ,血中疟原虫清除时间分别为 3 0和 60h ,均差异有极显著性 (P <0 .0 1)。结论 :青蒿琥酯治疗恶性脑型疟疾作用迅速 ,副作用小 ,对耐奎宁株有效 ,可作为奎宁治疗失败的首选药物。Objective:To probe into the clinical therapeutic effectiveness of artesunate in the treatment of cerebral malaria. Methods:64 patients with cerebral malaria diagnosed by demonstration of plasmodium falciparum in thick drop blood smears were randomly divided into 2 equal groups. Patients of the treatment group ( n =32) were given each an initial dose of 2.4 mg·kg 1 of artesunate dissolved in 1 mL of 5% sodium bicarbonate solution and added to 10 mL of 5% glucose solution administered by slow IV injection. 12 h later, a second dose of 1.2 mg·kg 1 of artesunate was given in the same way. For the succeeding 6 days, a daily dose of 1.2 mg·kg 1 of artesunate was given in the same manner to each of the patients of the treatment group. Patients of the control group ( n =32) were given each an initial dose of 20 mg of quinine dissolved in 500 mL of 5% glucose solution administered by IV instillation, which was completed within 4 h. 8 h later, a second dose of 10 mg·kg 1 of quinine was given in the same way. Thereafter, 10 mg·kg 1 of quinine was given q.8.h. in the same manner until the patients could take medicines by mouth. Quinine tablets in a dose of 10 mg·kg 1 were then given q.8.h. PO to each patient of the control group until a course of treatment of 7 days was completed. Results:Artesunate started to act quickly, being rapid to control the symptoms of malaria. The cure rates on the 7th day of the treatment were 90.6% and 87.5% in the artesunate group and quinine group,respeclively, the difference being insignificant( P >0.05). The times of abatement of fever were 24 h and 48 h, and those of blood plasmodium elimination were 30 h and 60 h in patients of the artesunate group and quinine group,respectively,the differences being highly significant( P <0.01). Conclusion:Both artesunate and quinine were shown to be effective in the treatment of cerebral malaria. However, artesunate was found to act more quickly in the treatment of pernicious cerebral malar

关 键 词：青蒿琥酯 奎宁 脑型疟疾 治疗 临床疗效 寄生虫病 不良反应 

分 类 号：R531.3[医药卫生—内科学] R978.61[医药卫生—临床医学]