摘要
目的总结输入性恶性疟临床特点及治疗方法,为其诊断和治疗提供科学依据。方法对2007年1月-2013年2月山东省寄生虫病防治所收治的138例输入性恶性疟病例的临床资料进行分析。结果 138例病人全部来自非洲国家,临床表现以发热、头痛、乏力、肝脾肿大为主,实验室检查多有红细胞、血小板计数降低,乳酸脱氢酶水平升高。有36.96%的病例被误诊为呼吸系统疾病、肾炎、肝炎等。采用蒿甲醚、伯氨喹、青蒿琥酯、双氢青蒿素、双氢青蒿哌喹片等抗疟药治疗及对症治疗后,近期治愈率为98.55%,远期治愈率为94.93%,未愈1例,死亡1例。结论青蒿素类仍是最有效的抗恶性疟药物,但部分病例因体内疟原虫对该药存在抗药性或敏感性下降而复燃。应重视重症疟疾的早期抗疟及对症治疗,以提高治愈率、降低死亡率。
Objectives To summarize the clinical characteristics of imported falciparum malaria patients and the treatment,so as to provide the evidences for improving the diagnosis and treatment of the disease. Methods A total of 138 imported falciparum malaria patients who received the treatment in Shandong Institute of Parasitic Diseases from January 2007 to February2013 were adopted as the observation subjects,and their clinical data were collected and analyzed. Results All the 138 patients were back from African countries. The main manifestations were fever,headache,asthenia,and hepatosplenomegaly,and most of them were with decreased RBC,PLT levels and increased LDH levels,and 36.96% of them were misdiagnosed as respiratory diseases,nephritis,hepatitis and so on. Through antimalarial treatment of artemether or artesunate or dihydroartemisinin and primaquine,or dihydroartemisinin and piperaquine,and symptomatic treatment,the short-term and long-term cure rates were 98.55% and 94.93% respectively,with 1 case unrecovered and 1 died. Conclusions Artemisinins are still the most effective antimalarial drugs for falciparum malaria. However,some patients recrudesce as the Plasmodium in their body is resistant or insensitive to these drugs. We should pay more attention to the antimalarial and symptomatic treatments in the early stage of severe malaria so as to improve the cure rate.
出处
《中国血吸虫病防治杂志》
CAS
CSCD
2014年第6期669-671,677,共4页
Chinese Journal of Schistosomiasis Control
关键词
恶性疟
输入性疟疾
治疗效果
青蒿素
Falciparum malaria
Imported malaria
Therapeutic effect
Artemisinins
