双氢青蒿素治疗37例疟疾患者的疗效观察

为评价双氢青蒿素对疟疾的疗效，以双氢青蒿素总剂量４８０ｍｇ的７天疗法治疗３７例疟疾患者，其中恶性疟２５例，间日疟１２例。２５例恶性疟患者中５例为早期脑型疟，３例并发血红蛋白尿。２５例的平均末梢血疟原虫数为７３２１８／μｌ，治疗后平均退热时间为３６．２４±１５．３０小时，平均原虫转阴时间为４４．８０±１９．０９小时。随访２１例，１例在１９天后复燃，复燃率为４．８％。１２例间日疟患者的平均血疟原虫数为４９５０／μｌ，治疗后平均退热时间为１６．７５±１４．５５小时，平均原虫转阴时间为２９±９．５２小时，其中１例在３５天后复发，经再次双氢青蒿素及伯喹治疗后痊愈。全部病例服药后无明显不良反应。     

双氢青蒿素对恶性疟疾的疗效及免疫调节作用观察

目的观察双氢青蒿素对恶性疟疾患者的疗效,红细胞及体液免疫的调节作用。方法患者每天1次口服60mg双氢青蒿素片,连续服用7d。用药前、后对所有患者进行红细胞C3b受体花环率（RBC-C3b）和红细胞免疫复合物花环率（RBC-ICR）,血清IgG和IgM检测。结果68例患者均获临床治愈,平均退热时间为（26.6±12.8）h,外周血原虫转阴率为89.71%（61/68）,仅见6例患者发生恶心、腹痛和呕吐等副反应。治疗后,患者RBC-C3b升高、RBC-ICR降低,血清IgG、IgM水平下降,与治疗前比较差异均有显著性（P〈0.01）。结论双氢青蒿素是治疗恶性疟较为理想的一种药物,其不仅可以改善症状,且可提高机体免疫功能。     

磷酸咯萘啶及其合并双氢青蒿素治疗疟疾效果观察

目的 观察国产抗疟药磷酸咯萘啶单方和磷酸咯萘啶合并双氢青蒿素在厄利特里亚治疗疟疾的近期疗效。方法 以显微镜血检疟原虫阳性者为观察对象,服药后逐日血检疟原虫,观察治疗效果。结果 单方治疗间日疟与恶性疟的原虫平均转阴时间分别为32.00h和50.18h;联合治疗间日疟与恶性疟的原虫平均转阴时间分别为24.00h和27.69h;联合治疗抗氯喹恶性疟平均转阴时间为24.00h。两组药物治疗的病人均于治疗结束前体温恢复正常。未见明显副反应。首次治疗后7d,单方组有55.56%的恶性疟病例携带配子体,高于联合用药的18.18%。结论 联合用药优于单用,但两组药物对当地疟疾均100%临床治愈,有良好的近期疗效。     

磷酸咯萘啶及其合并双氢青蒿素治疗疟疾效果观察

目的观察国产抗疟药磷酸咯萘啶单方和磷酸咯萘啶合并双氢青蒿素在厄利特里亚治疗疟疾的近期疗效.方法以显微镜血检疟原虫阳性者为观察对象,服药后逐日血检疟原虫,观察治疗效果.结果单方治疗间日疟与恶性疟的原虫平均转阴时间分别为32.00 h和50.18 h;联合治疗间日疟与恶性疟的原虫平均转阴时间分别为24.00 h和27.69 h;联合治疗抗氯喹恶性疟平均转阴时间为24.00h.两组药物治疗的病人均于治疗结束前体温恢复正常.未见明显副反应.首次治疗后7 d,单方组有55.56%的恶性疟病例携带配子体,高于联合用药的18.18%.结论联合用药优于单用,但两组药物对当地疟疾均100%临床治愈,有良好的近期疗效.     

双氢青蒿素治疗恶性疟与间日疟的效果

双氢青蒿素为抗疟新药,具有速效、安全的优点。为进一步评价其疗效和不良反应,在云南抗氯喹恶性疟流行区勐腊等地,进行了临床观察。　　材料和方法1　药物双氢青蒿素,为北京第六制药厂产品,批号931103。2　剂量分组A组:双氢青蒿素80mg·d-1×5d,首剂加倍。总量480mg。B组:双氢青蒿素60mg·d-1×7d,首剂加倍,总量480mg。C组:与B组相同。儿童剂量依年龄递减。3　对象疟疾现症病人,外周血原虫无性体数>500/μl血,7d内未服用过抗疟药、磺胺类、四环素和砜类药者。4　观察方法病人入院后,按入院顺序,恶性疟病人单号入A组,双号入B组,间日疟病人…     

蒿甲醚和双氢青蒿素治疗维和部队疟疾93例分析

目的 为了保证维和部队的任务完成及官兵的身体健康,防治维和部队的疟疾患者并总结疟疾的防治经验.方法 对所属维和部队官兵参与进行抗疟药物分组治疗效果观察.结果 双氢青蒿素(科泰新)防治效果肯定,用于进人高疟区的易感人群疟疾防治效果显著.结论 蒿甲醚对疟疾的疗效肯定;双氢青蒿素作为一种新的选择更适应未来的战争需要.     

Pharmacokinetics of dihydroartemisinin in a murine malaria model

Pharmacokinetic properties of dihydroartemisinin (DHA) were determined in mice given 100 mg/kg intraperitoneal DHA. Half-life, CL/F, and V/F were 25 min, 61.3 L/hr/kg, and 36.3 L/kg in malaria-infected mice and 19 min, 50.9 L/hr/kg, and 23.0 L/kg in controls. These data are valuable for pharmacokinetic-pharmacodynamic evaluations of DHA in murine models.     

Dose findings of dihydroartemisinin in treatment of falciparum malaria

Forty patients with uncomplicated P. falciparum malaria were respectively treated in an open randomized comparative study of dihydroartemisinin tablets given at total doses of 480 mg over 5 days and 640 mg over 7 days in a drug-resistant malaria endemic area in Hainan, China. The result showed that all patients were clinically cured. In 5-day and 7-day groups, the mean fever clearance times (FCT) were 26.1+/-10.2 and 21.1+/-11.8 hours respectively; the mean parasite clearance times (PCT) were 58.7+/-20.9 and 59.4+/-20.9 hours respectively, which showed no significant difference. 28-day follow-ups were accomplished on 39 and 37 cases respectively in two groups, the recrudescence rates were 20.5% (8/39) in 5-day group, while 2.7% (1/37) in 7-day group with significant difference (chi2=4.19, p<0.05). No clinical drug-related side effect was found in two groups during treatment.     

A comparative clinical trial of combinations of dihydroartemisinin plus azithromycin and dihydroartemisinin plus mefloquine for treatment of multidrug resistant falciparum malaria

With the deteriorating situation of multidrug resistant falciparum malaria, a new drug or drugs in combinations are urgently needed. We conducted a study comparing a combination of dihydroartemisinin 240 mg and mefloquine 1,250 mg given over 3 days (Group 1) and a combination of dihydroartemisinin 240 mg and azithromycin 1,500 mg given over 3 days (Group 2), to determine safety, efficacy and tolerability. All of the patients stayed in a non-malaria endemic area during the study. By the third day after drug administration, most patients were free of parasites and none had serious adverse events. The cure rates at day 28 were 100% and 69.7% in Group 1 and Group 2, respectively (p<0.01). We conclude that a combination of dihydroartemisnin and azithromycin was safe and effective and may be another interesting regimen of the treatment of uncomplicated multidrug resistant Plasmodium falciparum malaria in Thailand.     

Parenteral chloroquine for treating falciparum malaria

There is no information and therefore no consensus on how chloroquine should be administered to persons with severe malaria. Although widely considered dangerous, parenteral chloroquine is extensively used. We studied the acute disposition and toxicity of intravenous (iv), intramuscular (im), subcutaneous (sc), and oral chloroquine in 60 adult Zambian patients hospitalized with falciparum malaria. Plasma concentration profiles after parenteral administration were characterized by wide fluctuations between peak and trough values. Absorption of im and sc chloroquine was rapid, with a median time to peak concentration of 30 min and a peak plasma concentration five times higher than after oral administration. The pharmacokinetic data suggest that the acute toxicity of parenteral chloroquine is related to transiently high concentrations in blood and result from incomplete distribution out of a relatively small central compartment. Parenteral chloroquine may be administered safely by simply giving smaller, more-frequent doses than are currently used or, in the case of iv administration, by using continuous infusion.     

Falciparum malaria and pregnancy.

Falciparum malaria in pregnancy is a significant health problem in India. Pregnant women constitute an important high risk group for malaria infection which may cause abortion, still births, intra uterine growth retardation (IUGR), and pre-mature labour. Two hundred eighty-eight admitted female patients of falciparum malaria were included in the study out of which 45 were pregnant. The mortality rate was highly significant in pregnant females (37.77%) in comparison to non-pregnant females (14.81%); (p < 0.001). The incidence of various pernicious syndromes including cerebral malaria, severe anaemia (Hb < 5 g%) hepatic and renal failure were more in pregnant females in comparison to non-pregnant females. The incidence of infection was higher among primigravida and second gravida 30/45 (66.66%) as compared to multigravida 15/45 (33.33%) and the greater incidence of infection was seen during 14-28 wk of gestation 23/45 (51.11%). Pregnancy related complications in the form of preterm live birth (20%). Intra uterine death (IUD 31.11%), still births (13.33%) and abortions (11.11%) were more pronounced in primiparous women as compared to multiparous. Weight of placenta in majority of patients ranged between 200-400 g (22/31; 70.96%). Normal pregnancy continued in only 11 out of 45 pregnant females, out of which seven had low birth weight body (63.63%). As the pregnancy is associated with increased incidence and adverse outcome of falciparum malaria infection, chemoprophylaxis should be made an integral part of antenatal care along with antianaemic therapy to reduce the risk of serious maternal and fetal complications.     

Risk factors for placental malaria and its effect on pregnancy outcome in Yaounde, Cameroon

Between 1996 and 2001, the prevalence of placental malaria in pregnant women living in Yaounde, Cameroon and its effect on pregnancy outcome were evaluated with respect to gravidity and maternal age. Results showed that 19.9% of the women had placental malaria at delivery. After adjusting for relevant covariates, the major risk factor for placental malaria was an age < 25 years old. Placental malaria significantly increased the prevalence of anemia in women regardless of gravidity or age. In addition, the mean infant birth weight was lower and the percentage of pre-term deliveries (PTDs) and low birth weight (LBW) babies were higher in primigravidae and women < 20 years of age who had placental malaria. However, in a multivariate regression model taking relevant covariates into consideration, the major risk factor for PTDs was maternal anemia, and maternal anemia as well as first and second pregnancies were important risk factors for LBW babies.     

Electrocardiographic safety evaluation of dihydroartemisinin piperaquine in the treatment of uncomplicated falciparum malaria

Dihydroartemisinin-piperaquine (DP) could become a leading fixed combination malaria treatment worldwide. Although there is accumulating evidence of efficacy and safety from clinical trials, data on cardiotoxicity are limited. In two randomized controlled trials in Thailand, 56 patients had ECGs performed before treatment, 4 hours after the first dose, and 4 hours after the last dose. The mean (95% CI) changes in QTc interval (Bazett's correction) were 2 (-6 to 9) ms and 14 (7 to 21) ms, respectively. These small changes on the third day of treatment are similar to those observed elsewhere in the convalescent phase following antimalarial treatment with drugs known to have no cardiac effects and are therefore likely to result from recovery from acute malaria and not the treatment given. At therapeutic doses, DP does not have clinically significant effects on the electrocardiogram.