目前针对恶性和非恶性疟疾患者的循证治疗方法

A. Sydorchuk, V. Moskaliuk
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引用次数: 0

摘要

疟疾是国际卫生当局关注的一个主要问题,也是一种可能危及生命的疾病,因为世界上每年有数百万人因一种由传染性雌性按蚊媒介传播的疟原虫属寄生虫而遭受痛苦。由于寄生虫生物学和遗传学的复杂性,目前还没有疫苗。疟疾患者可能出现发烧和多种症状。20世纪下半叶出现了对氯喹(治疗疟疾最常用的药物)具有耐药性的疟疾寄生虫菌株(主要是恶性疟原虫)。虽然耐药性在地理上传播,但它也在化学上进化,包括对其他抗疟疾药物,如奎宁、磺胺多辛、乙胺嘧啶和proguanil。研究的目的。描述由不同种类的寄生虫引起的疟疾的病原学和流行病学的现代方面;并通过分析其化疗的最佳循证建议来突出临床特点。我们在Scopus、Cochrane数据库和ncbi图书馆(Pubmed)中检索了关键词为“恶性疟疾治疗”、“良性疟疾”、“良性疟疾”、“疟疾与妊娠”、“抗疟药耐药性”的科学论文。目前,在世界范围内,已知有六种由疟原虫引起的基因不同的人类疟疾。这种病媒传播的感染可通过蚊子、血液制品、肝移植和胎盘从孕妇传播给胎儿。如果怀疑有任何类型的疟疾,应根据旅行记忆和世卫组织以及国家建议,建议及时治疗。甲地米星与甲氟喹或甲苯曲明联合治疗比单药治疗效果更好。对于卵圆弧菌和间日弧菌,磷酸伯氨喹对预防复发至关重要。乌克兰是每年发病的东欧国家,因为与旅行和就业有关的奇异病例。对发热、发冷、出汗、肝脾肿大的患者,应采用血浓滴、血薄涂片的寄生虫镜检方法检查是否有寄生虫存在。在疟疾流行国家,在计划前往亚热带和热带地区之前,必须在所有时间内使用现有抗疟疾药物进行化学预防。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CURRENT THERAPEUTIC EVIDENCE BASED APPROACHES TO PATIENTS WITH FALCIPARUM AND NON-FALCIPARUM MALARIA
Malaria is a major concern for international health authorities and potentially lifethreatening disease because of millions of people suffer every year in the world dueto a parasite of the Plasmodium genus transmitted by an infective female Anophelesmosquito vector. Due to the complexity of the parasite biology and genetics, there iscurrently no vaccine. Individuals with malaria may present with fever and a wide rangeof symptoms. The second half of the 20th century saw the emergence of strains of malariaparasites (mainly P.falciparum) resistant to chloroquine, which was the most commonlyused drug for treatment of the disease. While resistance spread geographically, it alsoevolved chemically including to other antimalarial drugs like quinine, sulfadoxine,pyremethamine, and proguanil.The aim of research. To describe modern aspects of etiology and epidemiology ofmalaria, caused by different species of parasite; and to highlight clinical peculiaritieswith analysis of the best evidence based recommendations of its chemotherapy.Methods. We had used scientific paper searching in Scopus, Cochrane databases, andNCBI library (Pubmed) by key words as “malignant tertian malaria treatment”, “benigntertian malaria”, benign quartana malaria”, “malaria and pregnancy”, “resistance toantimalarials”.Results. Nowadays there are six known genetically different species of Plasmodiumcaused malaria disease in human worldwide. This vector-borne infection may transmitvia mosquito, blood products, a liver transplantation and through placenta from pregnantto fetus. If suspected any malaria type, promptly therapy should be suggest accountedtravel anamnesis and WHO as well as national recommendations. Therapy containedarthemisin in combination with lumefantrine or mefloquine is better and more effectivethan monotherapy. In case of P.ovale and P.vivax primaquine phosphate is essential topreclude recrudescences.Conclusions. Ukraine is the eastern European country with annual morbidity becauseof exotic cases connected with travels and employment. In case of fever, chills, sweats,hepatosplenomegaly patient should be tested for parasite presence by methods ofparasitoscopy of thick drop and thin smear of blood. Chemoprophylaxis within allduration in endemic country by available antimalarial should be obligatory beforeplanning to subtropical and tropical regions.
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