日本血吸虫病低度流行区吡喹酮薄膜衣片临床疗效及不良反应评价

Evaluation on the therapeutic efficacy and adverse effects of film-coated praziquantel tablet against Schistosoma japonicum infection in low-endemicity areas

目的：评价日本血吸虫病低度流行区吡喹酮薄膜衣片对血吸虫病患者的疗效。方法选择1个血吸虫病低度流行村，对5~60岁常住居民采用毛蚴孵化法进行粪检，并统计患者感染度（EPG）。阳性者分别采用60mg/kg或40mg/kg吡喹酮薄膜衣片进行病原学治疗。治疗6周后粪检复查，评估吡喹酮薄膜衣片疗效，阳性者采用相同治疗进行第2次治疗；同时观察吡喹酮服药后的不良反应发生情况。结果87例观察对象中，有吡喹酮抗虫治疗史1次者43例，2次以上者44例；中度感染37例（EPG：216~312），轻度感染50例（ EPG：24~96）；第1次治疗使用吡喹酮薄膜衣片60mg/kg 37例，40mg/kg 50例，复查均未查见毛蚴或虫卵。患者不良反应发生率为17.24%。结论在日本血吸虫病低度流行区，吡喹酮薄膜衣片对血吸虫感染者具有较高敏感性。

Objective To evaluate the therapeutic efficacy of film-coated praziquantel tablet in the treat-ment of patients infected with Schistosoma japonicum（S. japonicum） in areas with low endemicity. Methods The dwellers aged 5 to 60 years from villages of low endemicity received stool examination for the S. japoni-cum infection using miracidium hatching test, and the positive cases were given etiological intervention with film-coated praziquantel tablet in dose of 60 or 40 mg/kg. Miracidium hatching test was performed after 6 weeks of medication to assess the therapeutic efficacy, and those that remained positive underwent the second treatment using the same protocol. All adverse events associated with praziquantel treatment were observed. Results Of the 87 subjects, 43 had a history of once praziquantel treatment, and 44 a history of twice or over. Thirty-seven cases had moderate infection （EPG, 216-312）, and 50 mild infection （EPG, 24-96）. Re-exami-nation with miracidium hatching test detected no S. japonicum miradium or egg following treatment with film-coated praziquantel tablet in dose of 60 mg/kg in 37 cases and 40 mg/kg in 50 cases. The incidence of adverse reactions was 17.24%. Conclusion The therapeutic efficacy of film-coated praziquantel tablet remains sensitive to patients infected with S. japonicum in areas with low endemicity.