超声影像在肝包虫病疗效考核中的价值

对阿苯达唑治疗的６２例单纯型和多子囊型肝包虫病人，用Ｂ超诊断仪进行动态声像图分析，时间为１．０—３．５年，观察囊径、囊年增长率，声像图变化规律与疗效之间的关系，发现单纯型囊肿疗效好于多子囊型，而且囊径大小与疗效关系密切，囊径在５９ｍｍ以下与６０ｍｍ以上者治愈率差别显著（Ｐ＜０．０５），以５９ｍｍ以下疗效较好，治愈率达５８％。经阿苯达唑治疗的囊肿由正常增长率１５．４％变为负增长（－９．４％），表明药物可显著抑制包虫的增殖增长，而且声像图也呈现出一定的变化规律，这些特征为临床疗效评价提供了一定依据。     

Study of electrochemical oxidation and determination of albendazole using a glassy carbon-rotating disk electrode

In this work, electrochemical oxidation of albendazole (ABZ) was carried out using a glassy carbon-rotating disk electrode. Development of electroanalytical methodology for ABZ quantification in pharmaceutical formulations was also proposed by using linear sweep voltammetric technique. Electrochemical oxidation is observed for ABZ at E(1/2)=0.99 V vs. Ag/AgCl(sat), when an anodic wave is observed. Kinetic parameters obtained for ABZ oxidation exhibited a standard heterogeneous rate constant for the electrodic process equal to (1.51+/-0.07) x 10(-5) cm s(-1), with a alphan(a) value equal to 0.76. Limiting current dependence against ABZ concentration exhibited linearity on 5.0 x 10(-5) to 1.0 x 10(-2) mol l(-1) range, being obtained a detection limit of 2.4 x 10(-5) mol l(-1). Proposed methodology was applied to ABZ quantification in pharmaceutical formulations.     

阿苯达唑脂质体和阿苯达唑片治疗囊型包虫病的临床疗效及安全性

目的 观察阿苯达唑脂质体(L-ABZ)和阿苯达唑片(T-ABZ)治疗囊型包虫病的临床疗效及安伞性.方法 收集1998-2008年我院门诊收治及下乡现场普查发现的囊型包虫病患者269例,采用回顾性病例对照方法,纳入符合病例218例,其中经L-ABZ治疗的患者110例,经T-ABZ治疗的患者108例.依据随访的临床症状及影像和血清学化验结果对比分析药物的疗效及不良反应.短期为服药3个月,长期为服药6个月.囊型包虫病患者分为单囊型(CE1)、多子囊型(CE2)和内囊塌陷坏死型并囊内可见活性子囊(CE3).用χ2检验分析计量资料、计数资料;用Wilcoxon秩和检验分析等级资料;统计学检验均为双侧检验,统计数据均用SPSS13.0及PEMS3.1医学统计软件分析完成.结果 短期疗效评价中,L-ABZ组与T-ABZ组总有效率及治愈率分别为77.9%和49.1%,28.4%和13.9%,两组比较,χ2值分别为19.581、6.877,P值均<0.05,差异有统计学意义.长期疗效评价中,L-ABZ组与T-ABZ组总有效率及治愈率分别为81.7%和49.0%,47.6%和20.6%,两组比较,χ2值分别为20.977、15.049,P值均<0.05,差异有统计学意义.T-ABZ组不同类型包虫囊肿疗效比较:对于短期治愈率、短期总有效率、长期治愈率、长期总有效率,CE1组分别为50.0%(15/30)、56.7%(17/30)、58.3%(7/12)、75.0%(9/12);CE2组分别为8.8%(8/91)、35.2%(32/91)、28.6%(12/42)、69.0%(29/42);CE3组分别为33.3%(7/21)、61.9%(13/21)、70.0%(7/10)、100.0%(10/10).CE1组、CE3组分别与CE2组的短期疗效(治愈率和总有效率)比较,χ2值分别为24.887、4.329、8.860、5.076,P值均<0.05,差异有统计学意义;L-ABZ组不同类型包虫囊肿疗效比较:对于短期治愈率、短期总有效率、长期治愈率、长期总有效率,CE1组分别为47.4%(18/38)、92.1%(35/38)、79.3%(23/29)、96.6%(28/29).CE2组分别为12.2%(12/98)、65.3%(64/98)、35.9%(23/64)、84.40/0(54/64).CE3组分别为61.5%(8/13)、92.3%(12/13)、50.0%(3/6)、100%(6/6).CE1组、CE3组分别与CE2组的短期疗效(治愈率、总有效率)比较,χ2值分别为19.648、9.930、18.880、3.876,P值均<0.05,差异有统计学意义;在安全性评价中,T-ABZ组和L-ABZ组药物相关的不良反应发生率分别为11.1%(12/108)、12.7%(14/110),两组比较,χ2=0.155,P>0.05,差异无统计学意义.结论 L-ABZ及T-ABZ均是有效的抗包虫药物,但L-ABZ临床疗效更佳.

Abstract：

Objective To explore and compare the clinical effect and safety of liposomal albendazole (L-ABZ) and tablet-albendazole (T-ABZ) in the treatment of cystic echinococcosis (CE1, CE2, and CE3). Methods A total of 269 cases treated with cystic echinococcosis (CE) in Xinjiang Medical University the First Affilicated Hospital from 1998 to 2008 were reviewed. 51 cases were excluded and 218 cases were enrolled in this research by retrospective case-control method. Among 110 cases were treated with L-ABZ and 108 cases were treated with T-ABZ for short-term (3 months) and long-term courses (6 months) respectively. The effects and safety of the two medicines were compared by analyzing the clinical symptoms, imaging check and serologic test results. Results In short-term effect evaluation, the total effective rates and curative rates of L-ABZ group and T-ABZ group were 77.9% and 49.1% vs 28.4% and 13.9%, respectively. The effects of L-ABZ group was better than that of T-ABZ group, with remarkable difference in total effective rates and curative rates ( χ2 value was 19.581, 6.877, respectively, P < 0.05). In long-term effect evaluation, the total effective rates and curative rates of L-ABZ and T-ABZ group were 81.7% and 49.0% vs 47.6% and 20.6%, respectively. There was significant difference between L-ABZ group and T-ABZ group in total effective rates and curative rates (χ2 value was 20.977, 15.049, respectively, P < 0.05). In T-ABZ group the short-term curative rates were 50.0% (15/30), 8.8% (8/91) and 33.3% (7/21) respectively in CE1, CE2, and CE3, the short-term total effctive rates were 56.7% (17/30), 35.2% (32/91) and 61.9% (13/21) respectively in CE1, CE2, and CE3. The long-term curative rates were 58.3% (7/12), 28.6% (12/42) and 70.0% (7/10) respectively in CE1, CE2 and CE3, the long-term total effctvie rates were 75.0% (9/12), 69.0% (29/42) and 100.0% (10/10) respectively in CE1, CE2, and CE3. When compared with CE2, differences existed in CE1 ( χ2 = 24.887,4.329; P < 0.05) and CE3 groups ( x 2 = 8.860, 5.076; P < 0.05) in terms of short-term effects. In L-ABZ group, the short-term curative rates were 47.4% (18/38), 12.2% (12/98) and 61.5% (8/13) respectively in CE1, CE2 and CE3, the short-term total effctive rates were 92.1% (35/38), 65.3% (64/98) and 92.3% (12/13) respectively in CE1, CE2 and CE3, the long-term curative rates were 79.3% (23/29), 35.9% (23/64) and 50.0% (3/6) respectively in CE1, CE2 and CE3, the long-term total effective rates were 96.6% (28/29),84.4% (54/64) and 100% (6/6) respectively in CE1, CE2 and CE3. When compared with CE2, there were significant differences in CE1 (χ2 = 19.648, 9.930; P < 0.05) and CE3 groups ( χ2 = 18.880, 3.876; P < 0.05) in terms of short-term effect. In L-ABZ and T-ABZ groups, the durg-related adverse effects were 11.1% (12/108) and 12.7% (14/110) respectively without significant difference ( χ2 = 0.155, P > 0.05). Conclusion L-ABZ and T-ABZ were both effective anti-echinococcosis drugs without dominant sideeffects. The clinical effect of L-ABZ was better than that of T-ABZ.     

Surgical Techniques and Treatment for Hepatic Hydatid Cysts

Purpose Hepatic hydatid cysts (HHCs) are a parasitic infestation caused by several species of Echinococcus. We examined the clinical features of HHCs and evaluated the results of various surgical procedures. Methods One hundred and sixty-nine patients aged between 17 and 84 years underwent surgery for HHCs within a 12-year period. We recorded the demographic data, location of the cysts, surgical procedures used, morbidity, recurrences, and hospital stay. Results Most (90.5%) of the patients presented with symptoms, but 16 (9.5%) patients reported no symptoms. The most common symptom was abdominal pain. The overall number of cysts was 216 HHCs and 9 concomitant hydatid cysts in other abdominal organs. The surgical treatments consisted of hepatic resection in 8 (4.7%) patients, cystostomy with drainage in 43 (25.5%), cystostomy with capitonnage in 22 (13%), cystostomy with omentoplasty in 72 (42.6%), and cystectomy in 24 (14.2%). Splenectomy or nephrectomy was also performed in nine patients. Postoperative complications developed in 36 (21.3%) patients, and three suffered recurrences. The postoperative mortality rate was 1.2%. Postoperative complications were more frequent after cystostomy with capitonnage than after cystostomy with omentoplasty (P < 0.001) or cystectomy (P = 0.0037). The additional procedures prolonged the hospital stay. Conclusions Current surgical techniques combined with antiscolicidal therapy using albendazole are effective and safe treatments for HHCs, associated with low morbidity, mortality, and recurrence rates.     

从文献回顾分析抗蠕虫药物的现状与发展趋势

目的 运用文献计量学方法对已发表的抗蠕虫药物文献进行分析,探讨抗蠕虫药物的现状和发展趋势。方法　 收集在PubMed数据库上收录的1997-2007年医学专业学术期刊抗蠕虫药物的相关文献,通过一定数据准入标准筛选符合要求的文献并构建Access数据库。对数据库中相关文献进行如“研究类型”、 “发表年代”、 “涉及药物”等分类项归类。用SPSS17.0软件对数据进行相应的线性回归和二次回归等统计学分析。 结果 抗蠕虫药物相关论文年度发表数量呈逐年增长趋势,年相关论文发表量增加约6篇;应用性研究为主要研究主题;主要研究病种依次为血吸虫病、丝虫病、蛔虫病、棘球蚴病和钩虫病,其中血吸虫病相关文献数量最多,与其他4种主要蠕虫病的相关文献数量差异均有统计学意义（P<0.05）;主要研究药物为阿苯达唑、吡喹酮、甲苯咪唑、伊维菌素和乙胺嗪;抗蠕虫药物相关文献在多种医学杂志上发表,发表抗蠕虫药物文献数量第1位和第10位的期刊分别占文献总数的5.52%和 1.63%。 结论 近10年来抗蠕虫药物愈来愈受到重视,但其种类不多,亟需发展新药。     

Liver enzymes derangement and the influence of diet in animals given oral albendazole

Background:

Albendazole is used as an anthelmintic in the treatment of some parasitic infections. This study determined how the effects of albendazole on liver enzymes are influenced by diet.

Materials and Method:

Thirty adult male Wistar rats of mean weight 304.12 ± 11.34 g were randomly grouped into five: Group A: Control, was given rat pellets and water only; Group B received 15 mg/kg/d of albendazole while fasting; Group C received 15 mg/kg/d of albendazole with fatty meal; Group D received 15 mg/kg/d of albendazole with normal diet (rat pellets); and, Group E received 30 mg/kg/d of albendazole with normal diet (rat pellets); they were given orally for 3 consecutive days. The animals were sacrificed thereafter and blood samples obtained for quantitative study of the serum activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP).

Results:

Significant elevation in the serum levels of the transaminases especially in animals which were on their normal diet (rat pellets), while ALP was either reduced or increased based on dietary factors.

Conclusions:

Oral administration of albendazole before meal or with a fatty diet could help limit severe elevation of liver enzymes associated with its use, while still ensuring optimal efficacy.     

新药三苯双脒治疗蛔虫,鞭虫和挠虫感染的临床观察

为观察三苯双脒（Ｔｒｉｂｅｎｄｉｍｉｄｉｎｅ）治疗蛔虫、鞭虫和晓虫感染的效果及副作用,对成人蛔虫感染和鞭虫感染随机分组,比较服用单剂三苯双脒３００ｍｇ和单剂阿苯达唑４００ｍｇ驱除蛔虫的效果;比较用单剂三苯双脒４００ｍｇ,每日一次,连服３天和阿苯达唑同样剂量和疗程驱除鞭虫的效果;对儿间晓虫感染（６￣８岁）用单剂三苯双脒２００ｍｇ和阿苯达唑２００ｍｇ阿苯达唑２００ｍｇ顿服的驱虫效果进行比较。结果     

不同浓度阿苯达唑体外抗微小膜壳绦虫形态学研究

应用形态学方法观察比较了不同浓度的阿苯达唑体外对微小膜壳绦虫及其虫卵的损伤作用。结果显示 ,48h各实验组虫体活力明显下降 ,72 h高浓度组虫体均死亡。虫体损伤主要表现在两个方面 :1皮层损伤。出现皮层水肿增粗、绒毛脱落 ,皮层区基底膜及皮下肌细胞脱落 ;2实质区损伤。海绵状实质区呈空网格状高度透亮 ,出现空泡 ,排泄管明显扩张 ,细胞有核固缩、核碎裂现象发生。且随着药物浓度升高和作用时间延长 ,组织损伤愈加严重。48h虫卵出现形态改变 ,数量明显减少。表明阿苯达唑对微小膜壳绦虫及其虫卵均具有较强的损伤作用     

中山市2个社区居民华支睾吸虫感染情况及阿苯达唑疗效分析

目的 了解中山社区居民华支睾吸虫感染情况,评价阿苯达唑治疗的效果,为制定华支睾吸虫病防控策略提供科学依据。方法 在2个华支睾吸虫病防控综合示范区收集社区居民大便,采用改良加藤氏涂片法检查华支睾吸虫卵。对检查阳性者给予阿苯达唑片口服治疗, 2次/d,2片/次（0.2 g/片）,连服4 d;16岁以下儿童剂量减半。治疗后3周收取第二份粪便进行复查。结果 共调查532人,感染96人,感染率为18.05%。男性、女性感染率分别为28.63%（69/241）和9.28%（27/291）,差异有统计学意义（[χ2] = 334.99,P < 0.01）;感染率随着年龄的增长而上升,不同年龄组之间的感染率差异有统计学意义（[χ2] = 63.84,P < 0.01）。96例感染者中参与治疗94例,参与复查86例。79例转阴,转阴率为91.86%。未转阴的7例中,5例存在不规律服药情况。参与治疗病人未报告严重不良反应。结论 中山市2个社区的居民,尤其是男性和高年龄人群华支睾吸虫感染率较高。阿苯达唑治疗效果较好,安全性较高。下一步应加强普查普治,降低居民感染率。     

阿苯达唑脂质体治疗66例人体包虫病的疗效观察

目的综合评价阿苯达唑脂质体(L-ABZ)治疗人体包虫病的疗效,并进行安全性考察,为该药在临床的应用提供客观依据.方法临床治疗了66例包虫病患者,其中囊型包虫病56例、泡型包虫病10例,口服阿苯达唑脂质体10mg*kg-1*d-1,一天两次,连续服用,疗程3～12个月,通过影像学指标观察,结合临床症状和体征及生化指标进行综合评价,动态随访3～24个月.按治愈率、有效率、部分有效率、无效率以及总有效率判断疗效,并对单囊型及与多子囊型以及原发、复发病人进行对照分析.结果共治愈20例(20/66),治愈率为30.3%;有效29例(29/66),有效率43.9%;部分有效10例(10/66),部分有效率15.1%;无效7例(7/66),无效率10.6%;总有效率为89.3%(59/66).其中,单囊型的治愈率明显高于多子囊型,但二者的有效率无显著性差异(P<0.1);而原发、复发病人的治疗阿苯达唑脂质体的疗效无明显差异(P＞0.1);泡型包虫病患者,约50%病例临床疗效明显.在安全性观察中,主观症状阳性率为13.6%(9/66),生化指标阳性率为12.1%(8/66).结论阿苯达唑脂质体口服液是目前有效的一种抗包虫病新药剂型,具有疗效较高,低毒、副作用小、安全性高的特点.