青蒿素片治疗恶性疟108例的效果

EFFICACY OF QINGHAOSU TABLET ON 108PATIENTS WITH FALCIPARUM MALARIA

在海南省抗氯喹／抗哌喹恶性疟流行区，选择１０８例恶性疟现症病人，单用青蒿素片剂按总剂量与疗程天数，分成４ｇ５ｄ（３１例）、３ｇ３ｄ（３９例）和２．５ｇ２ｄ（３８例）三组治疗验证。三组治前几何平均原虫密度分别为１８０９８、１８４６２和１６５６３／μｌ，治后平均退热时间分别为２８．９±１６．７ｈ、３１．７±１７．７ｈ和３１．０±１４．４ｈ；平均原虫无性体转阴时间分别为３５．４±１１．５ｈ、３９．０±１４．６ｈ和３３．７±１２．８ｈ，即时疗效相似（Ｐ＞０．０５）。追踪随访２８ｄ的治愈率４ｇ５ｄ组为８６．２％，与３ｇ３ｄ组和２．５ｇ３ｄ组的４５．２％和３６．４％比较，差异非常显著（Ｐ＜０．０１）。三组病例药物副反应轻微。结果可见：第１ｄ顿服青蒿素片１ｇ，第２～５ｄ每天一次服０．７５ｇ的４ｇ５ｄ疗程，是目前应用青蒿素片剂治疗抗药性恶性疟疗效较好的治疗方案。

In the endemic areas of chloroquine-resistant falciparum malaria in Hainan Is-land,108 patients with falciparum malaria were treated by three regimens of Qinghaosu tablet:4g/5d(31 cases),3g/3d(39 cases)and 2.5g/2d(16)(38 cases).In the three groups,the geomet-ric mean parasite density was 18 098,18 462 and 16 563(GMPD/μl)respectively before treat-ment.After treatment, the mean time of fever subsidence was 28.9±16.7h,31.7±17.7 and 31.0±14.4h, and the average clearance time of asexual parasite was 35.4±11.5h, 39.0±14.6h and33.7±12.8h respectively. The efficacies of the three regimens were similar( P >0.05),but thecurative rate in the group of 4g/5d during the 28-day follow-up was 86.2%,compared withthat of 45.2%in the group of 3g/3d and that of 36.4%in the group of 2.5g/2d. The differenceis considerably significant(P<0.01 ).In all the groups no marked side effect was observed.The results suggest that the regimen of 4g/5d,i.e.taking 1g of Qinghaosu tablet in the first dayand 0.75g once a day for the rest 2-5 days is a good regimen in the applicaton of Qinghaisutablet against drug-resistant falciparum malaria.