双氢青蒿素治疗37例疟疾患者的疗效观察

EFFICACY OF DIHYDROARTEMISININ IN TREATMENT OF 37 MALARIA CASES

为评价双氢青蒿素对疟疾的疗效，以双氢青蒿素总剂量４８０ｍｇ的７天疗法治疗３７例疟疾患者，其中恶性疟２５例，间日疟１２例。２５例恶性疟患者中５例为早期脑型疟，３例并发血红蛋白尿。２５例的平均末梢血疟原虫数为７３２１８／μｌ，治疗后平均退热时间为３６．２４±１５．３０小时，平均原虫转阴时间为４４．８０±１９．０９小时。随访２１例，１例在１９天后复燃，复燃率为４．８％。１２例间日疟患者的平均血疟原虫数为４９５０／μｌ，治疗后平均退热时间为１６．７５±１４．５５小时，平均原虫转阴时间为２９±９．５２小时，其中１例在３５天后复发，经再次双氢青蒿素及伯喹治疗后痊愈。全部病例服药后无明显不良反应。

Dihydroartemisinin is an efficacious derivative of artemisinin which can be taken orally in treatment of malaria with less side reactions. Thirty seven cases with malaria were treated with this drug in Beijing and in Ruili City, Yunnan Province. Out of them, 25 cases suffered from falciparum malaria with an average parasitemia of 73 218/μl and 12 from vivax malaria with an average parasitemia of 4 950/μl . The dosage was 60mg daily or 2mg/kg for paediatric patients for 7 successive days with the first dose doubled. All the patients were clinically cured after treatment. Fever subsided 22～72 hours after the beginning of treatment in falciparum malaria patients with an average fever clearance time of 36.24±15.30 hours and their parasite clearance time was 24～72 hours with an average parasite clearance time of 44.80±19.09 hours. One of them had recrudescence 19 days after the disappearance of parasites, hence the recrudescence rate of falciparum malaria was 4.8%. Five early cerebral cases in this series were completely cured after the treatment. All the 12 cases with vivax malaria were also clinically cured after treatment, but 1 case had relapse 35 days after treatment. This patient was completely cured with another course of dihydroartemisinin combined with primaquine. All patients tolerated well the oral administration of dihydroartemisinin and no significant side reactions were seen.