甲氟喹治疗恶性疟与青蒿琥酯的随机比较

A Randomized_Controlled Study of Mefloquine and Artesunate in the Treatment of Falciparum Malaria

目的：评价甲氟喹治疗恶性疟的疗效与安全性。方法：采用甲氟喹７５０ｍｇ一次顿服与青蒿琥酯片５ｄ疗程总量６００ｍｇ各治疗无合并症恶性疟３０例，进行随机比较。结果：两组病例均能迅速控制临床症状，平均退热时间两组相似，分别为甲氟喹组（２４．２±１４．７）ｈ和青蒿琥酯组（１８．３±９．０）ｈ（ｔ＝１．８４３，Ｐ＞０．０５）。平均原虫转阴时间甲氟喹组（５７．２±２０．０）ｈ慢于青蒿琥酯组（４３．０±１７．１）ｈ（ｔ＝２．９０７，Ｐ＜０．０１）。追踪观察２８ｄ，甲氟喹组治愈率为７６．７％，原虫复燃率为２３．３％；青蒿琥酯组治愈率为７３．３％，复燃率为２６．７％，两组无显著性差异（χ２＝０．０８９，Ｐ＞０．０５）。两组除极少数患者可见轻微的恶心或呕吐，可能与病情本身有关外，未见其他明显毒副作用。结论：甲氟喹７５０ｍｇ一次顿服与青蒿琥酯５ｄ疗程总量６００ｍｇ治疗恶性疟的治愈率及症状控制疗效相似，甲氟喹组原虫清除时间慢于青蒿琥酯组。

Objective :To evaluate the effect and safety of mefloquine in treating falciparum malaria. Method:60 patients with uncomplicated falciparum malaria were randomly allocated to mefloquine and artesunate groups which were given a single dose of 750 mg mefloquine and 600mg artsunate as a total dose over 5 days respectively. The mean fever_subsidence time ( 24.2 ± 14.7 ) hin mefloquine group was similar to that ( 18.3 ± 9.0 )h in artesunate group (t= 1.843 , P> 0.05 ). The mean parasite_clearance time ( 57.2 ± 20.0 )h in mefloquine group was significantly longer than that ( 43.0 ± 17.1 )h in artesunate group (t=2.907, P< 0.01 ). The cure rate of mefloquine group was 76.7 %, 28_day recrudescence rate was 23.3 %,which showed no significant difference from that of artesunate group ( 73.3 % cured and 26.7 % recrudescence)(x 2= 0.089 ,P> 0.05 ). Slight nausea or vomiting were observed in few patients in two groups after treatment, which may be disease_related. No other side effect was found. Conclusion: The regimen of a single dose of 750 mg mefloquine and 600 mg artesunate as a total dose over 5 days resulted in a similar effect in term of cure rate, fever subsidence and symptoms control, yet parasite clearance time of mefloquine was longer than that of artesunate.