云南省恶性疟原虫对氯喹、氨酚喹、哌喹、甲氟喹、奎宁敏感性的体外测定

目的：了解云南省恶性疟原虫对氯喹、氨酚喹、哌喹、甲氟喹及奎宁的敏感性。方法：采用Ｒｉｅｃｋｍａｎｎ体外微量法测定采自云南省瑞丽１１个县、市的恶性疟原虫对以上药物的敏感性。结果：云南省南部、东南部及西部恶性疟原虫对氯喹抗性率分别为９６．７％、７８．９％及９５．７％,ＩＤ５０依次为１２５ｎｍｏｌ／Ｌ、１３６ｎｍｏｌ／Ｌ、及１７６ｎｍｏｌ／Ｌ;对氯酚喹的抗性率分别为１００％、８５．３％及８８．９％,ＩＤ５０依次为５２ｎｍｏｌ／Ｌ、５４ｎｍｏｌ／Ｌ及７２ｎｍｏｌ／Ｌ;对奎宁均为敏感,ＩＤ５０依次为４８０ｎｍｏｌ／Ｌ、３５２ｎｍｏｌ／Ｌ及６０８ｎｍｏｌ／Ｌ。南部及东南部原虫对哌喹的抗性率分别为６８及８８ｎｍｏｌ／Ｌ;结论：云南省恶性疟原虫对４－氨基喹啉类药物普遍产生抗性,其抗性程度来自滇西及其相连的缅甸感染的疟原虫明显高于滇东南;对奎宁及甲氟喹敏感。氯喹、氨酚喹及哌喹目前已不适应于云南恶性疟的治疗

ASSAY OF SENSITIVITY OF PLASMODIUM FALCIPARUM TO CHLOROQUINE,AMODIAQUINE,PIPERAQUINE, MEFLOQUINE AND QUININE IN YUNNAN PROVINCE *

AIM: To determine the sensitivity of P. falciparum to chloroquine, amodiaquine, piperaquine, mefloquine and quinine in Yunnan Province of China in 1992-1995. METHODS: Rieckmann's in vitro microtechnigue was used. The sensitivity of P. falciparum was tested to the above-mentioned antimalarials. RESULTS: The resistance rates of isolates of P. falciparum from the south, southeast and the west part of Yunnan to chloroquine and amodiaquine were 96.7% (29/30), 78.9% (30/38), 95.7% (22/23) and 100% (30/30), 85.3% (29/34), 8/9, respectively, with their corresponding ID50 of 125 nmol/L, 136 nmol/L and 176 nmol/L, and 52 nmol/L, 64 nmol/L and 72 nmol/L, respectively. All the isolates were sensitive to quinine and their ID50 were 480 nmol/L, 352 nmol/L, 608 nmol/L, respectively. The resistance rates of P. falciparum from the south part and southeast part of Yunnan to piperaquine were 96.4% (27/29), 72.9 (27/37), respectively, their ID50 were 320 nmol/L and 228 nmol/L; all the cases were sensitive to mefloqine, their ID50 were 68 nmol/L and 88 nmol/L. CONCLUSION: P. falciparum generally produces resistance to chloroquine, amodiaquine and piperaquine in Yunnan Province; the degree of resistance to chloroquine of P. falciparum from the west part of Yunnan were higher than the P. falciparum from the southeast part of Yunnan; all the isolates were sensitive to mefloquine and quinine in this region.