阿奇霉素治疗先天性弓形虫病16例随访报告  

Follow up of 16 cases with congenital toxoplasmosis treated with azithromycin

作　　者：陈桂芳[1] 方荫槐[1] 郭德兴[1] 冯小伟[1] 向伟[1] 阮和球[1] 

机构地区：[1]海南省人民医院儿科,海口市570311

出　　处：《中华儿科杂志》2004年第1期23-25,共3页Chinese Journal of Pediatrics

摘　　要：目的　探讨阿奇霉素治疗先天性弓形虫病的疗效。方法　对有弓形虫病临床表现者 ,检查血弓形虫 (TOX)DNA ,循环抗原 (CAG) ,IgM三项 ,其中一项或一项以上阳性者 ,并排除其它的先天性感染疾病而确定诊断。用阿奇霉素 10mg/kg·d服用 6天 ,停 8天 ,服 2个月 ,间隔 1个月 ,视需要是否继续用药。疗程 2～ 8个 ,平均 5个疗程。随访 2 5～ 5年 ,平均 4年。结果　全部患儿均有效 ,病情逐步好转。 12例治疗 9个月～ 1 5年后复查弓形虫 4项 ,10例全部阴转 ,2例TOX IgG转为阳性。其余 4例作临床随访 ,症状消失。结论　 16例先天性弓形虫感染患儿服用阿奇霉素治疗 ,效果显著 ,未见明显毒副作用 。Objective To study the therapeutic effects of azithromycin in treatment of congenital toxoplasmosis in children Methods Definite diagnosis of congenital toxoplasmosis was made on the basis of clinical manifestation combined with one or more positive results of the following laboratory tests and excluded other congenital infectious diseases: toxoplasma DNA (TOX DNA), circulating toxoplasma antigen (TOX CAG), and toxoplasma IgM antibody (TOX IgM) All the patients were given oral azithromycin 10 mg/(kg·d) for 6 days followed by 8 days without medication (one course of treatment), and the regimen was persisted for 2 months and then another 2 month treatment was given at a 1 month interval The authors continued to provide further treatment according to the state of the illness at one month interval The patients received 2 to 8 (average 5) courses of treatment The patients were followed up for 2 5 to 5 (average 4) years Results The treatment was effective in all the patients and the patient′s condition was improved The authors repeated in 12 cases the four tests for toxoplasma (TOX DNA, TOX CAG, TOX IgM, and TOX IgG) 9 months to one and a half years after treatment In 10 cases all these tests showed negitive results, in 2 cases TOX IgG was postive and in the other 4 cases symptoms disappeared Conclusion The results of the study showed that oral azithromycin had significant therapeutic effects with little side effect and was well tolerated Azithromycin may become an alternative therapy in treatment of congenital Toxoplasma gondii infection in children

关 键 词：阿奇霉素 治疗 先天性弓形虫病 叠氮红霉素 诊断 临床资料 

分 类 号：R725.3[医药卫生—儿科]