摘要
研制成功涂药板和便于现场使用的培养基后,1980-2003年,采用体内四周法和体外微量法开展了我国抗氯喹恶性疟的抗性程度及地理分布;停用或减少使用氯喹防治恶性疟后,恶性疟原虫对氯喹抗性的消长及我国恶性疟原虫对常用抗疟药敏感性等调查。结果显示,有恶性疟流行的八省(区)均有抗氯喹恶性疟存在,其中海南和云南两省抗性程度高,分布地区广。停用或减少使用氯喹后,恶性疟原虫对氯喹抗性逐渐降低。海南和云南两省恶性疟原虫对氯喹、氨酚喹和哌喹有高度抗性,对咯萘啶和青蒿素类药物敏感,但敏感性在逐渐降低。根据调查结果,制定了抗疟药使用原则和用药方案,停止或减少使用已有抗性的抗疟药,推荐应用青蒿素类药物和咯萘啶及其复方。使抗疟药能合理规范使用,促进了疟疾防治,疟疾发病逐年降低,恶性疟流行区逐渐缩小。
Since the successful preparation of microplates and media for field use,the 4-week in vivo assay recommended by the WHO and an in vitro microassay were used to ascertain the extent to which Plasmodium falciparum was resistant to chloroquine and the geographical distribution of that parasite in China from 1980-2003.Fluctuations in the resistance of P.falciparumto chloroquine and the sensitivity of that parasite to antimalarials commonly used in China were investigated after halting or reducing the use of chloroquine used to control P.falciparum.Results indicated that chloroquine-resistant falciparum malaria was present in all 8provinces/autonomous regions where falciparum malaria is endemic.P.falciparum was highly resistant in Hainan and Yunnan provinces and was widely distributed.When the use of chloroquine was halted or reduced,the drug resistance of P.falciparumgradually decreased.In Hainan and Yunnan,P.falciparum was still highly resistant to chloroquine,amodiaquine,and piperaquine and sensitive to pyronaridine and artemisinin derivatives,but its sensitivity was gradually decreasing.Based on these findings,principles and regimens for antimalarial use in China were formulated.Once P.falciparumhas developed resistance to certain antimalarials,then their use is halted or reduced.Use of artemisinin derivatives or pyronaridine and other compounds is recommended to promote the rational use of antimalarials and enhance malaria control.Results indicated that the incidence of malaria has declined,and areas where falciparum malaria is endemic have gradually decreased since the mid-1980 s.
出处
《中国病原生物学杂志》
CSCD
北大核心
2014年第7期664-669,共6页
Journal of Pathogen Biology
关键词
疟原虫
恶性
抗药性
敏感性
抗疟药
体内试验
体外试验
监测
综述
Plasmodium falciparum
resistance
sensitivity
antimalarials
in vivo
in vitro
surveillance
review
