城市和农村急性血吸虫病人临床及吡喹酮治疗的比较研究

目的比较城市和农村急性血吸虫病人临床表现和吡喹酮治疗对体温影响的差异。方法将1994年城乡(芜湖市和繁昌县)两所专科医院住院治疗的急性血吸虫病人分成城市组和农村组。又将两组中单剂和双剂吡喹酮治疗的患者、儿童(≤14岁)和成年患者分别分为8个亚组作为交叉比较的单位。用常规剂量对两组患者治疗。比较两组患者误诊时间的长短,治疗前临床表现及其在各组病人中出现率,吡喹酮治疗后各组体温下降曲线,吡喹酮治疗的副反应及其出现率。结果两组患者的误诊天数无显著差异,表明无论在城市还是农村,血吸虫急性感染的误诊是普遍的;除发热外,急性血吸虫病人最主要的临床表现为畏寒,咳嗽,乏力,腹痛,腹泻等,城市患者的症状诉说比农村患者更多,更不集中。急性感染对两组患者的肝功能影响极小。城市组儿童单剂治疗后体温降至正常天数显著小于农村组,而双疗程组儿童,城市组明显长于农村组。而成人之间均无显著性差异。单疗程和双疗程的城乡两组人群体温下降趋势相同。结论城乡医院对急性血吸虫感染的误诊均相当普遍;城乡两组病人对吡喹酮的临床反应基本无差异;临床使用双疗程吡喹酮治疗急性感染者是合理和可行的。

STUDY ON CLINIC MANIFESTATIONS AND INFLUENCE OF PRAZIQUENTEL TO BODY TEMPERATURE COMPARING PATIENTS OF ACUTE SCHISTOSOMIASIS IN URBAN FROM THAT IN RURAL AREAS

Aim To compare the difference of the clinic manifestations and the influence of Praziquentel to the temperature between the patients of acute schistosomiasis in the urban and rural areas.Methods To group the acute pa- tients hospitalized in the two special clinics into the urban group(hospitalized in Wuhu city)and the rural group(hospitalized in Fanchang county)respectively and divide the two groups into eight subgroups,single and double dosage Praziquentel treatment,among the them child and adult were divided into the subgroups as com- parison units.all cases were treated with conventional dosage of Praziquentel.it was compared among the pa- tients of the subgroups that days of misdiagnosis of the disease,clinic amnifestations and its' occuring rates be- fore the treatment,and the curves of temperatures dropping after the treatment,and the side-effects of Praz- iquentel and its' occurring rates.Results No significant difference was found between the two groups in the days of misdiagnosis,which showed thay no matter in municipal clinic or in rural one diagnosis of acute schisto- somal infection were generally existed,except fever,chilly,cough,hypodynamia,abdominal pain,Diarrhea and so on.compliants on the manifestations for the patients in the urban seem more and not focus than that in rural,few Influence was existed for the hepatic function in the acute patients.Days of temperature dropping to the normal for the urban children were markedly less than that for the rural children in the single dosage sub- groups after the treatment,and in the double ones the days for the urban children were markedly longer than that for the rural children.No significant differences were found among the adult subgroups,and curves of the temperatures dropping were the same between the urban and rural groups of single and double subgroups.Con- clusion Misdiagnosis of acute schistosomal infection was markedly existed no matter in municipal or in rural hospitals.No markedly differences were found in the clinic side-effects of Praziquentel between the urban and rural patients.It is reasonable and possible to treat the acute schistosomal infection with double dosages of Praz- iquentel.