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.
目的 觀察阿苯達唑脂質體(L-ABZ)和阿苯達唑片(T-ABZ)治療囊型包蟲病的臨床療效及安傘性.方法 收集1998-2008年我院門診收治及下鄉現場普查髮現的囊型包蟲病患者269例,採用迴顧性病例對照方法,納入符閤病例218例,其中經L-ABZ治療的患者110例,經T-ABZ治療的患者108例.依據隨訪的臨床癥狀及影像和血清學化驗結果對比分析藥物的療效及不良反應.短期為服藥3箇月,長期為服藥6箇月.囊型包蟲病患者分為單囊型(CE1)、多子囊型(CE2)和內囊塌陷壞死型併囊內可見活性子囊(CE3).用χ2檢驗分析計量資料、計數資料;用Wilcoxon秩和檢驗分析等級資料;統計學檢驗均為雙側檢驗,統計數據均用SPSS13.0及PEMS3.1醫學統計軟件分析完成.結果 短期療效評價中,L-ABZ組與T-ABZ組總有效率及治愈率分彆為77.9%和49.1%,28.4%和13.9%,兩組比較,χ2值分彆為19.581、6.877,P值均<0.05,差異有統計學意義.長期療效評價中,L-ABZ組與T-ABZ組總有效率及治愈率分彆為81.7%和49.0%,47.6%和20.6%,兩組比較,χ2值分彆為20.977、15.049,P值均<0.05,差異有統計學意義.T-ABZ組不同類型包蟲囊腫療效比較:對于短期治愈率、短期總有效率、長期治愈率、長期總有效率,CE1組分彆為50.0%(15/30)、56.7%(17/30)、58.3%(7/12)、75.0%(9/12);CE2組分彆為8.8%(8/91)、35.2%(32/91)、28.6%(12/42)、69.0%(29/42);CE3組分彆為33.3%(7/21)、61.9%(13/21)、70.0%(7/10)、100.0%(10/10).CE1組、CE3組分彆與CE2組的短期療效(治愈率和總有效率)比較,χ2值分彆為24.887、4.329、8.860、5.076,P值均<0.05,差異有統計學意義;L-ABZ組不同類型包蟲囊腫療效比較:對于短期治愈率、短期總有效率、長期治愈率、長期總有效率,CE1組分彆為47.4%(18/38)、92.1%(35/38)、79.3%(23/29)、96.6%(28/29).CE2組分彆為12.2%(12/98)、65.3%(64/98)、35.9%(23/64)、84.40/0(54/64).CE3組分彆為61.5%(8/13)、92.3%(12/13)、50.0%(3/6)、100%(6/6).CE1組、CE3組分彆與CE2組的短期療效(治愈率、總有效率)比較,χ2值分彆為19.648、9.930、18.880、3.876,P值均<0.05,差異有統計學意義;在安全性評價中,T-ABZ組和L-ABZ組藥物相關的不良反應髮生率分彆為11.1%(12/108)、12.7%(14/110),兩組比較,χ2=0.155,P>0.05,差異無統計學意義.結論 L-ABZ及T-ABZ均是有效的抗包蟲藥物,但L-ABZ臨床療效更佳.
목적 관찰아분체서지질체(L-ABZ)화아분체서편(T-ABZ)치료낭형포충병적림상료효급안산성.방법 수집1998-2008년아원문진수치급하향현장보사발현적낭형포충병환자269례,채용회고성병례대조방법,납입부합병례218례,기중경L-ABZ치료적환자110례,경T-ABZ치료적환자108례.의거수방적림상증상급영상화혈청학화험결과대비분석약물적료효급불량반응.단기위복약3개월,장기위복약6개월.낭형포충병환자분위단낭형(CE1)、다자낭형(CE2)화내낭탑함배사형병낭내가견활성자낭(CE3).용χ2검험분석계량자료、계수자료;용Wilcoxon질화검험분석등급자료;통계학검험균위쌍측검험,통계수거균용SPSS13.0급PEMS3.1의학통계연건분석완성.결과 단기료효평개중,L-ABZ조여T-ABZ조총유효솔급치유솔분별위77.9%화49.1%,28.4%화13.9%,량조비교,χ2치분별위19.581、6.877,P치균<0.05,차이유통계학의의.장기료효평개중,L-ABZ조여T-ABZ조총유효솔급치유솔분별위81.7%화49.0%,47.6%화20.6%,량조비교,χ2치분별위20.977、15.049,P치균<0.05,차이유통계학의의.T-ABZ조불동류형포충낭종료효비교:대우단기치유솔、단기총유효솔、장기치유솔、장기총유효솔,CE1조분별위50.0%(15/30)、56.7%(17/30)、58.3%(7/12)、75.0%(9/12);CE2조분별위8.8%(8/91)、35.2%(32/91)、28.6%(12/42)、69.0%(29/42);CE3조분별위33.3%(7/21)、61.9%(13/21)、70.0%(7/10)、100.0%(10/10).CE1조、CE3조분별여CE2조적단기료효(치유솔화총유효솔)비교,χ2치분별위24.887、4.329、8.860、5.076,P치균<0.05,차이유통계학의의;L-ABZ조불동류형포충낭종료효비교:대우단기치유솔、단기총유효솔、장기치유솔、장기총유효솔,CE1조분별위47.4%(18/38)、92.1%(35/38)、79.3%(23/29)、96.6%(28/29).CE2조분별위12.2%(12/98)、65.3%(64/98)、35.9%(23/64)、84.40/0(54/64).CE3조분별위61.5%(8/13)、92.3%(12/13)、50.0%(3/6)、100%(6/6).CE1조、CE3조분별여CE2조적단기료효(치유솔、총유효솔)비교,χ2치분별위19.648、9.930、18.880、3.876,P치균<0.05,차이유통계학의의;재안전성평개중,T-ABZ조화L-ABZ조약물상관적불량반응발생솔분별위11.1%(12/108)、12.7%(14/110),량조비교,χ2=0.155,P>0.05,차이무통계학의의.결론 L-ABZ급T-ABZ균시유효적항포충약물,단L-ABZ림상료효경가.
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.
