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过去虽多次报道东非有抗氯喹的恶性疟,但大多是用体内方法测试的。由于该法可能受宿主的免疫耐受性、重复感染、吸收障碍及伴用其他药物等因素的影响。因此,目前认为临床上考虑抗药性的病例,需测定血清氯喹浓度或用体外技术评价。本文报道意大利的一例感染肯尼亚株恶性疟原虫的病人,经体外试验,证实对氯喹有高度的抗性。患者36岁,男性,于1982年秋到肯尼亚旅游15天之前未到过其他疟疾流行区,也未服过抗疟药。在返回意大利的第2天,出现高烧、头痛、关节痛,6天后,未经血检和就医便开始服氯喹,服药后次日入院,血检发现恶性疟原虫(4,500/μl),当给予氯喹治疗,连服5天,每日450mg,总量3,300mg,治疗期间无呕吐及腹泻。治后第3天,体温正常,症状
In the past, although there were many reports of Plasmodium falciparum resistant to chloroquine in East Africa, most of them were tested in vivo. As the law may be affected by host immune tolerance, repeated infections, malabsorption and other drugs with other factors. Therefore, the current consideration of drug resistance in clinical cases, the need to determine the concentration of serum chloroquine or in vitro techniques. This article reports an Italian case of Plasmodium falciparum infection in Kenya patients, in vitro tests confirmed that chloroquine has a high degree of resistance. The patient, 36 years old, males, had not been to other malaria-endemic areas 15 days prior to traveling to Kenya in the fall of 1982 and had not taken anti-malaria drugs. On the second day after returning to Italy, high fever, headache and arthralgia occurred. After 6 days, chloroquine started to be taken without blood examination and medical treatment. Plasmodium falciparum (4,500 / μl) was found on the next day after taking the medicine. When chloroquine Treatment, and even served 5 days, 450mg daily, the total amount of 3,300 mg, no vomiting and diarrhea during treatment. 3 days after treatment, normal body temperature, symptoms