阿苯达唑和吡喹酮治疗华支睾吸虫感染的比较

阿苯达唑和吡喹酮治疗华支睾吸虫感染的比较／刘宜生等／／中华传染病杂志，１９９４，１２（２）：１７７本文应用阿苯达唑和吡喹酮治疗华支睾吸虫病１０４例，随机分为３组。Ⅰ组３６例，男、女各１８例，平均年龄１４．７岁，阿苯达唑１４ｍｇ／ｋｇ，每日２次口服３天...     

吡喹酮与甲苯达唑药盐治疗福建棘隙吸虫病的疗效比较

目的：探讨用吡喹酮与甲苯达唑药盐治疗福建棘隙吸虫病的效果。方法：对１０９例粪检福建棘隙吸虫卵阳性者随机分为４组，分别用吡喹酮（Ａ）５ｍｇ／ｋｇ；（Ｂ）２．５ｍｇ／ｋｇ顿服与甲苯达唑（Ｃ）总剂量８００ｍｇ，８０ｍｇ／ｄ，连服１０ｄ；（Ｄ）总剂量４００ｍｇ，４０ｍｇ／ｄ，连服１０ｄ（药盐）治疗，于治后１ｗｋ和４ｗｋ复查，以虫卵阴转率和减少率为评价疗效。结果：４ｗｋ后上述４组阴转率依次为１００％、９２．３％、８５．２％和７１．４％；虫卵减少率为８４．８％—１００％，Ａ、Ｂ组疗效显著优于Ｄ组。结论：吡喹酮（２．５—５ｍｇ／ｋｇ）疗效高，疗程短，服药简便，为治疗本病的首选药物；甲苯达唑疗效尚可，在伴有肠道线虫感染时可用５００ｍｇ治疗。     

吡喹酮、阿苯达唑及其二者配伍治疗微小膜壳绦虫病的疗效观察

为了寻找一种安全、方便、有效的治疗微小膜壳绦虫病的药物和方法,将 １０５ 例微小膜壳绦虫感染者随机分为５ 组（包括对照组）,分别用吡喹酮 ６０ ｍ ｇ／ｋｇ 顿服、吡喹酮 １５ ｍ ｇ／ｋｇ 顿服同时伍用阿苯达唑１００ ｍ ｇ／ｄ×３ｄ、阿苯达唑２００ ｍ ｇ／ｄ×３ ｄ 和吡喹酮１５ ｍ ｇ／ｋｇ 顿服４ 种方法进行治疗。各治疗组的阴转率和对照组的自然阴转率在治疗后 １ 周分别为 ９０．４８％ 、９５．００％ 、４０．００％ 、１００％ 和 １２．５％ ;治疗后 １ 个月分别为 ９５．２４％ 、９５．００％ 、３５．００％ 、８４．２１％ 和 ２０．００％ ;治疗后半年为 ７６．１９％ 、６３．１６％ 、４６．１５％ 和６２．５０％ （无对照组）。结果表明,小剂量与大剂量吡喹酮治疗的效果均很明显,集体驱虫防治微小膜壳绦虫病以１５ ｍ ｇ／ｋｇ 为宜。阿苯达唑有一定的治疗效果,但协同增效作用不明显。     

复方阿苯达唑驱除肠道线虫的现场观察

目的：观察复方阿苯达唑（每片含阿苯达唑６７ｍｇ和噻嘧啶８３．３ｍｇ基质）的驱虫效果。方法：对成人钩虫感染者１８６４例、蛔虫感染者１５６８例和鞭虫感染者１７８５例及儿童蛲虫感染者３７３例，随机分组，比较服用单剂复方阿苯达唑３片或２片与单剂阿苯达唑４００ｍｇ或噻嘧啶３０ｍｇ（含基质１０ｍｇ）／ｋｇ的驱虫效果和副作用。结果：成人复方阿苯达唑３片和２片的虫卵阴转率，钩虫分别为６５．０％和５２．７％（Ｐ＜０．０１），蛔虫均为１００％，鞭虫分别为２６．５％和１９．２％（Ｐ＜０．０１）。３片的驱钩虫效果显著优于阿苯达唑和噻嘧啶组（Ｐ均＜０．０１）。２片的驱钩虫效果亦优于噻嘧啶（Ｐ＜０．０１），与阿苯达唑无显著性差异，但驱鞭虫效果低于阿苯达唑。２－６岁儿童服复方阿苯达唑１．５片的，蛲虫卵阴转率为１００％，显著优于噻嘧啶（Ｐ＜０．０１）。复方阿苯达唑的驱虫作用快速，副作用轻，对血象、肝肾功能和心电图无显著影响。结论：复方阿苯达唑具有阿苯达唑和噻嘧啶两药的协同作用。     

吡喹酮、阿苯达唑剂量递增疗法治疗脑囊虫病415例疗效观察

应用吡喹酮（ＰＱＴ）、阿苯达唑（ＡＬＢ）３种疗法治疗脑囊虫病４１５例：１．ＰＱＴ３０ｍｇ／ｋｇ·ｄ×１２，第２、３疗程为３０～５０ｍｇ／ｋｇ·ｄ×１２，疗程间隔２～３个月。２．ＰＱＴ１０ｍｇ／ｋｇ·ｄ×１２，递增至３０～５０ｍｇ／ｋｇ·ｄ×１２，疗程间隔２～３个月。３．ＡＬＢ、ＰＱＴ联合治疗，共３个疗程。总治愈率为８８．４３％，总有效率为９９．７６％。     

甲苯达唑、阿苯达唑和吡喹酮对继发性细粒棘球蚴囊液游离氨基酸含量的影响

对感染了继发性细粒棘球蚴的小鼠，于吡喹酮（Ｐｒａ）５００ｍｇ／ｋｇ／ｄ、甲苯达唑（Ｍｅｂ）２５ｍｇ／ｋｇ／ｄ或阿苯达唑（Ａｌｂ）３００ｍｙｋｇ／ｄ治疗１４天后，取包囊液测定了其中１８种游离氨基酸的含量，发现吡喹酮组小鼠囊液中有２种氨基酸的浓度高于对照组，有３种氨基酸的浓度低于对照组。而甲苯达唑组和阿苯达唑组囊液中的氨基酸浓度均低于对照组，其中各有１４种和１３种氨基酸含量明显低于对照组，表明甲苯达唑和阿苯达唑可干扰细粒棘球蚴囊的氨基酸代谢。     

阿苯达唑和吡喹酮治疗沙鼠泡球蚴病的病理学观察

观察阿苯达唑和吡喹酮治疗沙鼠泡球蚴的病理形态学改变、肝脏组织内泡球蚴形态变化和泡球蚴囊周组织反应。为观察疗效，将肝脏泡球蚴分为Ⅰ级：衰退性囊泡、Ⅱ级：静止性囊泡和Ⅲ级：增殖性囊泡。结果显示：阿苯达唑剂量较大组（５０ｍｇ／ｋｇ·ｄ）Ⅰ级囊率最高（Ｐ＜０．０５），其次为吡喹酮两组。早期治疗组比晚期治疗组Ⅰ级囊率为高。泡球蚴囊周淋巴细胞数以阿苯达唑治疗组为高（１０６．９±３４．３—３００．１±５９．５）（Ｐ＜０．０００１）。联合用药组无明显提高疗效作用。     

吡喹酮脂质体、吡喹酮、阿苯达唑、氟苯达唑和甲苯达唑对泡球蚴病的疗效观察

本文对小鼠继发性腹腔泡球蚴病用吡喹酮脂质体、吡喹酮、阿苯达唑、氟苯达唑和甲苯达唑进行实验治疗。５个治疗组对小鼠均能抑制泡球蚴增殖生长，抑制率分别为６８．７％，１４．３％，７０．０％，４８．３％和７７．０％。吡喹酮经脂质体包裹后，较吡喹酮组疗效明显提高（Ｐ＜０．０１）。各治疗组泡球蚴生发层均有不同程度损伤，与实验对照组有显著性差异（Ｐ＜０．０１），以吡喹酮脂质体对泡状棘球蚴损伤程度最重。超微结构显示，各治疗组对小鼠泡球蚴组织均有广泛的变化，以阿苯达唑组变化最重，细胞大部分解体。提示各种化疗药物对泡球蚴组织有广泛的细胞内效应。     

不同剂量吡喹酮治疗埃及血吸虫病1627例的临床观察

本文报道在马里共和国某医院工作期间，采用不同剂量吡喹酮治疗１６２７例埃及血吸虫病患者的临床疗效。甲组１１８７例，给以４０ｍｇ／ｋ，顿服；乙组３２１例，给以１０ｍｇ／ｋｇ，日服３次，连服２ｄ；丙组１１９例，给以５０ｍｇ／ｋｇ，顿服。治疗后３个月，镜检尿内虫卵，３组比较，以乙组疗法的疗效为最佳，虫卵阴转率达９６．６％，表明吡喹酮分次给药的方案较单次顿服为佳，且无药物副作用。     

阿苯达唑对感染仓鼠的美洲钩虫幼虫及虫卵的作用

感染美洲钩虫成虫的仓鼠口服阿苯达唑７５或１５０ｍｇ／ｋｇ的有效率为８３．８％和１００％。治前３ｄ，２个治疗组每鼠每ｇ粪便培养的幼虫数为２９７１６±３２９９和２８２５６±１１８，对照组的为８８２８±２６５９。治后３ｄ，治疗组的粪便培养未查见幼虫，而对照组的为９０６６±７４１６。此外，受治２组的培养粪便残渣用饱和盐水漂浮虫卵时，无或仅查见几个变性虫卵。仓鼠于感染第３期幼虫后３、７或１４ｄ口服１剂阿苯达唑１５０或３００ｍｇ／ｋｇ时，粪便虫卵阳性率为０－９．１％，减虫率为９６．８－１００％。     

Determination of the minmum effective dosages of praziquantel, albendazole, and mebendazole against Clonorchis sinensis infection in rats

In order to determine the minimum effective dosages of praziquantel, albendazole, and mebendazole against Clonorchis sinensis infection in Sprague-Dawley rats, each rat was infected with 30 metacercariae and treated with one of three drugs. The rats were killed and examined 25 days after praziquantel treatment or 11 days after albendazole or mebendazole treatment. The minimum effective dosages were a single dose of praziquantel 375 mg/kg, albendazole 150 mg/kg, and mebendazole 150 mg/kg. Trials are required to determine whether these dosages are useful in the treatment of human clonorchiasis.     

Albendazole therapy for neurocysticercosis

Seven patients with chronic parenchymal brain cysticercosis were treated with albendazole for one month at daily doses of 15 mg/kg of body weight. Computed tomographic follow-up studies were made at the following times: a mean of 16 months before the trial; the beginning of treatment; the end of treatment; and three months afterward. Computed tomographic studies at the beginning of treatment showed a total of 157 cysts, the last day of treatment the number had decreased to 39 cysts, and three months later, the total number of lesions was 22; this represents 86% improvement in the number of cystic lesions. Control studies in the same group of patients had shown chronic persistence of lesions without spontaneous improvement in most cases. Two patients had been treated with praziquantel previously with partial response; in both cases albendazole therapy was effective with 100% and 77% improvement. We conclude that albendazole is highly effective for the treatment of parenchymal brain cysticercosis. It is also effective in patients who had shown poor therapeutic response to praziquantel.     

Albendazole plus praziquantel versus albendazole alone as a pre-operative treatment in intra-abdominal hydatidosis caused by Echinococcus granulosus

Summary objective  To compare the effects of a combined medication of albendazole (10 mg/kg/day) plus praziquantel (25 mg/kg/day) to those of albendazole alone at different doses (10 and 20 mg/kg/day).
method  The protoscoleces9 viability was studied in a consecutive series of patients affected by intra-abdominal hydatidosis caused by Echinococcus granulosus . In all cases the drugs were given during the month prior to surgery.
results  A significant increase of patients with nonviable protoscoleces was observed in the group treated with the scolicides combination compared to those treated with albendazole alone, both at a dose of 10 mg/kg/day ( P = 0.004) and at a dose of 20 mg/kg/day ( P = 0.03). Albendazole sulphoxide levels in serum and in cyst fluid were higher in patients given the combined therapy than in those who received only albendazole (10 mg/kg/day: P = 0.016; 20 mg/kg/day: P = 0.034). Levels in the cysts were not significantly different probably due to the sample size; nevertheless a lineal relation between the values obtained in serum and inside the cysts could be discerned in the patients treated with the combined medication.
conclusion  Albendazole plus praziquantel is more effective than monotherapy with albendazole in the preoperative treatment of intra-abdominal hydatidosis.     

甲苯达唑、阿苯达唑和吡喹酮实验治疗小鼠继发性细粒棘球蚴病的观察

小鼠于感染继发性细粒棘球蚴后用甲苯达唑口服治疗,剂量为12.5～100mg/kg/d×10时囊肿抑制率为49.2～77.5％,用阿苯达唑100～300mg/kg/d×10～14治疗的为61.3～72.1％,而用吡喹酮400mg/kg/d,或800mg/kg/d,2次均服,疗程为10d时则无效,但若给服500mg/kg/d×14,囊肿抑制率为63.4％。药物有效各组的每鼠平均囊数,除个别组外,均较相应对照组的为少。此外,甲苯达唑与吡喹酮合并服用,有一定的增效作用。     

日本血吸虫病与肠线虫病联合化疗的效果

血吸虫病人合并感染肠线虫者(A组)采取;吡喹酮40mg/kg加阿苯达唑200mg和复方甲苯咪唑400mg(尚含左旋咪唑100mg)分2d顿服,1个半月后血吸虫阴转率88.0％,蛔虫、鞭虫和钩虫阴转率分别为77.4％、23.6％及100.0％。对不合并血吸虫病的肠线虫病患者采取两种联合化疗方案:B组—阿苯达唑200mg和复方甲苯咪唑200mg(尚含左旋咪唑50mg)顿服,蛔虫、鞭虫和钩虫的阴转率分别为66.7％、18.8％和62.5％,较A组结果稍低;C组—阿苯达唑100mg和噻嘧啶900mg顿服的驱虫效果差,蛔虫和鞭虫的阴转率分别为50.0％及11.1％。3种驱虫方案对血吸虫和蛔虫的减卵率可达97.0％～99.9％;对钩虫的减卵率达68.9％～100％;对鞭虫的效果差。相应增加药物的剂量及改进服法,当可提高疗效。     

A comparative trial of levo-praziquantel and praziquantel in the treatment of human Clonorchis sinensis infection]

Seventy patients with clonorchis sinensis infection were divided randomly into two groups and treated with levo-praziquantel and praziquantel in the same dosage of 12.5 mg/kg twice a day for two consecutive days (total dosage of 75 mg/kg). Follow-up stool examination three and six months after treatment showed that the egg negative conversion rates with levo-praziquantel group were 92.86% and 92.59%, while those of praziquantel group were 58.62% and 53.57% respectively. The results showed that levo-praziquantel was significantly superior to praziquantel (P < 0.001). The side reactions in both group were mild and transient.     

吡喹酮、甲苯达唑及阿苯达唑对细粒棘球蚴作用的组织化学比较

本文比较了吡喹酮、甲苯达唑及阿苯达唑对NIH鼠体内细粒棘球蚴组织化学的影响。结果表明,三种药物治疗3～14天,均能迅速引起生发层内糖原、AKP、ACP及ATP酶的减少、减弱或消失,以甲苯达唑组的为最明显,阿苯达唑及吡喹酮的较轻,但对生发层内DNA、RNA、蚤白质结合的酪氨酸、色氨酸、组氨酸以及碱性蛋白质的影响仅见于7及14天。亦以甲苯达唑组的较为显著。停药后,上述变化的恢复时间,吡喹酮及阿苯达唑的分别为14～30及30天,而甲苯达唑组的则需90天。     

A comparative trial of albendazole alone versus combination of albendazole and praziquantel for treatment of Trichuris trichiura infection

A randomized clinical trial was conducted to compare the effectiveness of albendazole alone and albendazole combined with praziquantel in the treatment of Trichuris trichiura infection. The drug regimens consisted of single dose of albendazole 400 mg (A1, n=34), 3 days of albendazole 400 mg daily (A3, n=34), 5 days of albendazole 400 mg daily (A5, n=35), single dose of albendazole 400 mg plus praziquantel 40 mg/kg (AIP1, n=34), and 3 days of albendazole 400 mg plus praziquantel 40 mg/kg daily (A3P3, n=36). It was found that treatment with 3 or more consecutive days of albendazole with or without praziquantel resulted in a significant reduction in density of Trichuris eggs in stools while a single dose of such drug did not. Praziquantel was not shown to have synergistic or antagonistic effects with albendazole. A regimen of 400 mg of albendazole daily for 3 days was found to be the most suitable therapy for Trichuris infection.     

Little effect of praziquantel or artemisinin on clonorchiasis in Northern Vietnam. A pilot study

The first choice for treatment of Clonorchis sinensis infections is praziquantel. Experimental data suggest that artemisinin derivatives are active against C. sinensis. The efficacy of both drugs against clonorchiasis was evaluated in a pilot study in clonorchiasis patients in an endemic area in the North of Vietnam. Twenty-one patients received praziquantel 25 mg/kg o.d. for three days, the regular regimen in that area, and 21 patients were treated with artemisinin 500 mg b.i.d. for 5 days. Faecal egg counts were performed before as well as 6 days and 5 weeks after treatment. In the praziquantel group the faecal egg count decreased significantly from a mean value of 1632 eggs per gram faeces (epg) to 37 epg 5 weeks after treatment (P < 0.01) but, surprisingly, the eradication rate (95% confidence limit) at week 5 was only 29% (11-52%). In the artemisinin-treated group the reduction of the egg count was insignificant: from 1103 to 542 epg (P > 0.05). The proportion of patients (95% c.l.) with C. sinensis eggs in their stool on week 5 was 90% (70-99%) in the artemisinin group and 71% (48-89%) in the praziquantel group (P > 0.05) and the eradication rate (95% c.l.) at week 5 was only 10% (1-30%). With a sensitivity of detection of eggs in stool > 0.89, this implies a statistically significant but clinically unsatisfactory reduction for treatment with praziquantel. Sensitivity is probably less. For artemisinin there was no significant reduction. In conclusion, for human clonorchiasis in the North of Vietnam, the efficacy of praziquantel 25 mg/kg o.d. for 3 days was unsatisfactory and artemisinin for 5 days is not an effective alternative.