双氢青蒿素对恶性疟原虫有性生殖期的影响

Effect of Dihydroartemisinin on the Sexual Stage of Plasmodium Falciparum

１８ 例带配子体的恶性疟患者随机分为２ 组： 双氢青蒿素组１０ 例， 口服５ ｄ 疗程总量３６０ ｍｇ ； 奎宁组８ 例， 口服７ ｄ 疗程总量１０ ５００ ｍｇ 。全部患者每天涂血片计算配子体密度， 于给药当天（Ｄ０） ， 药后４ 、７ 、１０ 、１４ 、２１ 和２８ ｄ （Ｄ４ 、Ｄ７ 、Ｄ１０ 、Ｄ１４ 、Ｄ２１ 、和Ｄ２８） 取血作大劣按蚊感染试验。患者血中配子体转阴时间， 双氢青蒿素组为２１ ．８ ±５ ．２ ｄ ； 奎宁组为３１ ．５ ±８ ．７ ｄ 。按蚊感染试验结果： 双氢青蒿素组有４ 例在Ｄ０Ｄ４ 、Ｄ７ 、Ｄ１０ 、Ｄ１４ 均未能感染按蚊； 其余６ 例于Ｄ０ 、Ｄ４ 、Ｄ７ 、Ｄ１０ 、Ｄ１４ 、Ｄ２１ 按蚊感染阳性例数为６／６ 、６／６ 、６／６ 、２／６ 、０／６ 和０／６ 。奎宁组Ｄ０ 、Ｄ４ 、Ｄ７ 、Ｄ１０ 、Ｄ１４ 、Ｄ２１ 和Ｄ２８ 按蚊感染阳性例数为４／８ 、８／８ 、８／８ 、８／８ 、８／８ 、２／８ 和０／８ 。这表明双氢青蒿素５ ｄ 总量３６０ ｍｇ 对恶性疟原虫有性生殖期发育有明显抑制作用， 对生理上未成熟的配子体， 可中断其发育。

Eighteen falciparumn malaria patients with gametocytemia were randomly allocated to 2 groups,treated respectively with dihydroartemisinin (DATM) tablets at a total dose of 360 mg over 5 days and with oral quinine sulfate (QN) at a total dose of 10 5000 mg over 7 days. Peripheral gametocyte counts were done daily in all patients until its disappearance. Blood samples were taken on D0, D4, D7, D10, D14, D21 and D28 from the patients to perform infectivity tests to Anopheles dirus. The result showed that the mean clearance times of PFG were 21.8±5.2 days in DATM group and 31.5±8.7 days in QN group respectively. And in DATM group, the infectivity tests were positive in 6 cases only. In those 6 positive cases, the numbers of the positive infectivity on D4, D7, D10, D14 and D21 were 6/6,6/6,2/6,0/6 and 0/6 respectively. While the 4 negative cases on D0 remained negative infectivity on D4, D7, D10, D14. In QN group, the infectivity tests were positive in 4 cases too on D0, the numbers of positive cases on D4, D7, D10, D14, D21 and D28 were 8/8,8/8,8/8,8/8,2/8 and 0/8 respectively. These indicate that QN cannot inhibit P.Falciparum at sexual stage, while DATM has a remarkable inhibitory effect, and may prevent the immatured PFG that was failure to infect An. dirus on D0 from maturing.