青蒿琥酯及其复方治疗抗氯喹恶性疟的初步观察

CURATIVE EFFECT OF ARTESUNATE AND COMPOUND ARTESUNATE TO CHLOROQUINE—RESISTANT FALCIPARUM MALARIA

用青蒿琥酯(青)240mg 治疗抗氯喹恶性疟24例;青240mg 与酮替芬12mg 3d 分服治疗9例;青240mg、磺胺多辛1000mg 和乙胺嘧啶70mg 治疗39例,三个组即时疗效相似,治后28d 内复燃率分别为52.9%、57.1%及17.6%。三个治疗方案对抗氯喹恶性疟具有显效快、近期疗效高等优点;青蒿琥酯、磺胺多辛及乙胺嘧啶伍用可显著提高抗氯喹恶性疟的根治效果。

A total of 72 falciparum malaria cases were divided into three groups and tested.24 cases in group Ⅰ were given artesunate(AT)60mg,0,4,24,48h respectively with a total dosage of 240mg;9 cases in group Ⅱ were given artesunate 240mg plus ketotifen(2mg,2 times a day for 3 days);while 39 cases in group Ⅲ were given artesunate 240mg,sulfadoxine(S)1000mg and pyrirnethamine(PY)70mg.The av- erage fever subsidence times in the three groups were in the order of 27±10h,35±22h and 27±15h;the asexual parasite clearance times 36±16h,20±10h and 31±10h;and the recrudescence rates 52.9%(9/ 17),57.1%(4/7)and 17.6(6/34)respectively.The resistant rates of Plasmodium falciparum to CQ (chloroquine)(n29)and AT(n21),as tested by the in vitro microtechnique,were 100% and 4.7% re- spectively. The results suggest that falciparum malaria was highly resistant to CQ,but sensitive to AT.The cases of recrudescence might not be due to the resistance of the parasite to AT but due to the low dose and short du- ration of treatment.Thus the combined use of AT/S/PY can reduce the recrudescence and the occurrence of cross-resistance of falciparum malaria to chloroquine.