利比里亚绥德鲁维和任务区恶性疟原虫对双氢青篙素哌喹片的抗药性观察

目的:观察恶性疟原虫对国产双氢青篙素哌喹片的在体抗药性。方法:回顾分析中国第13批驻利比里亚绥德鲁维和二级医院于2012年3月—2012年11月收治的69例恶性疟患者的临床资料。患者均口服双氢青蒿素哌喹片(商品名:科泰复,每片含双氢青蒿素40 mg、磷酸哌喹320 mg),首次剂量2片,6~8、24、32 h分别服2片,一个疗程总剂量8片;行快速疟原虫检测(rapid diagnostic test,RDT)及镜检以观察患者抗药性。结果:服药前显微镜下厚/薄血涂片镜检可见红细胞内环状体和(或)滋养体38例。治疗48 h后RDT阳性10例,转阴率85.5%(59/69),10例RDT阳性者镜检仍有2例可见环状体,此2例患者给予口服复方磷酸萘酚喹片治疗2 d,镜检转阴,初步判断疟原虫对双氢青蒿素哌喹片耐药率2.9%(2/69);其余8例未再服药,复查RDT均转阴(最迟1例于8 d后转阴)。结论:中国第13批驻利比里亚绥德鲁维和二级医院收治的恶性疟患者对国产双氢青篙素哌喹片耐药率较低。

Observation of Resistance of Plasmodium Falciparum to Dihydroartemisinin-Piperaquine Tablets in Peace- Keeping Task Region of Zwedru in Liberia

Objective：To assess in vivo resistance of Plasmodium falciparum to dihydroartemisinin-piperaquine tablets made in China. Methods：The clinical datum of 69 patients with falciparum malaria from March 2012 to November 2012 in the thirteenth peace keeping medical contingent in Chinese level-II hospital were retrospectively analyzed. I）ihydroartemisinin-piperaquine tab- let （trade name： Ketaifu, 40 mg dihydroartemisinin/320 mg piperaquine phosphate） was administered orally, with an initial dose of 2 tablets and 2 tablets at 6-8 h, 24 h and 32 h. The resistance of Plasmodium falciparum to dihydroartemisinin-pipera- quine tablets in patients was detected by rapid diagnostic test （RDT） and microscope inspection. Results： Before the treatment, RDT results were positive in all the 69 patients. There were 38 cases whose thick/thin blood smears showing ring form plasmo dium/sporadin in red cells before treatment. Positive RDT results were found in ten patients at 48 h after treatment. The nega- tive-turned rate was 85.5% （59/69）. Among the 10 cases, ring form plasmodium in red ceils could be found in 2 patients, and results turned negative after treatment with compound naphthoquine phosphate tables orally for 2 d. The resistance rate of Plasmodium falciparum to dihydroartemisinin- piperaquine tablets was 2.9% （2/69） according to preliminary inspection. No other drugs were given to the rest 8 case and their RDT results turned negative in succession during the next 8 d. Conclusions： In peace-keeping task region of Zwedru, the resistance rate of Plasmodium falciparum to dihydroartemisinin-piperaquine tablets made in China was low.