青蒿琥酯及蒿甲醚治疗G6PD缺乏的间日疟疗效观察

Observation on the effect of artesunate and artemether on patients with G6PD dificiency vivax malaria patients

目的评价青蒿琥酯及蒿甲醚治疗间日疟(G6PD)缺乏患者的疗效与安全性。方法采用A)青蒿琥酯静注5d疗程总量360mg和(B)蒿甲醚肌注3d疗程总量560mg各治疗间日疟30例,病例经G6PD活性检测《60%列为对象,住院7d,追踪观察至28d,进行随机比较。结果AB两组病例均能迅速控制临床症状,平均退热时间(d)分别为18。3d和19。2d。(38.3±0.4VS38.5±0.6)、平均原虫转阴时间(d)(16.3±22.23VS23.8±27.9)、治愈率(53.3%VS56.7%)、复燃率(46.7%VS43.3%)等方面均无显著差异(P>0.05)。两组极少数病例只见轻微的恶心或呕吐,未见其它明显毒副作用。结论青蒿琥酯及蒿甲醚治疗间日疟在控制症状、退热、原虫转阴等临床效果都很好,但复燃率很高。很难替换伯氨喹。

Objective To evaluate the efficacy and the safety of artesunate and artemether on patients with vivax malaria. Methods Thirty Vivax malaria cases with G6PD deficiency in group A were treated for 5 days with a total dase of 360mg of artesunate and another 30 vivax mamalaria cases with G6PD dificiency were treated for 3 days with a total dose of artemether of 560mg. Results The clinical symptoms of patients with vivax malaria in both groups were improved quickly. The mean fever clearance time in group A and B were 38.3±0.4days and 38.5±43.6 days, the average parasite clearance time were 16.3±22.2days and 23.8±27.9days, clinical cure rates were 53.3 % and 56.7 % , and relapse rates were 46.7% and 43.3 % respectively. No significient difference were observed in both groups. There were not significant side effect in both groups either. Conclusion Artesunate and artemether are effective for treatment of vivax malaria patients in controlhng clinical symptoms and clearance of parasite and fever. But relapse rates were high, thus they can not replace rimaquine.