摘要
目的观察阿苯达唑脂质体（L-ABZ）和阿苯达唑片（TABZ）治疗囊型包虫病的临床疗效及安全．眭。方法收集l998-2008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（CEl）、多子囊型（CE2）和内囊塌陷坏死型并囊内可见活性子囊（CE3）。用X^2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SPSSl3．0及PEMS3．1医学统计软件分析完成。结果短期疗效评价中，LABZ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，爿。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，X^2值分别为20．977、15．049，P值均〈0．05，差异有统计学意义。TABZ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，CEl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）、i00．0％（10／10）。CEl组、CE3组分别与CE2组的短期疗效（治愈率和总有效率）比较，X^2值分别为24．887、4．329、8．860、5．076，P值均〈O．05，差异有统计学意义；LABZ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，CEl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）、84．4％（54／64）。CE3组分别为61．5％（8／13）、92．3％（12／13）、50．0％0（3／6）、100％（6／6）。CEl组、CE3组分别与CE2组的短期疗效（治愈率、总有效率）比较，X^2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，X^2=0．155，P〉0．05，差异无统计学意义。结论L-ABZ及TABZ均是有效的抗包虫药物，但L-ABZ临床疗效更佳。
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 （X^2 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 effec- tive rates and curative rates （ X^2 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 （ X^2 = 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 （ X^2 = 19.648, 9.930; P 〈 0.05） and CE3 groups （ X^2 = 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 （ X^2 = 0.155, P 〉 0.05）. Conclusion L-ABZ and T-ABZ were both effective anti-ecbinococcosis drugs without dominant side- effects. The clinical effect of L-ABZ was better than that of T-ABZ.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2011年第7期532-536,共5页
Chinese Journal of Hepatology
基金
国家高技术研究发展计划重点课题子课题（2007AA021805）
关键词
包虫病
阿苯达唑
药物治疗
Hydatidosis
Albendazole
Pharmacotherapy
