NEITHER HEPARIN NOR ACETYLSALICYLIC-ACID INFLUENCE THE CLINICAL COURSE IN HUMAN PLASMODIUM-FALCIPARUM MALARIA - A PROSPECTIVE RANDOMIZED STUDY
NEITHER HEPARIN NOR ACETYLSALICYLIC-ACID INFLUENCE THE CLINICAL COURSE IN HUMAN PLASMODIUM-FALCIPARUM MALARIA - A PROSPECTIVE RANDOMIZED STUDY
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DOI：
10.4269/ajtmh.1991.45.608
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发表时间：
1991-11-01
影响因子：
3.3
通讯作者：
DIETRICH, M
中科院分区：
文献类型：
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作者：
HEMMER, CJ;KERN, P;DIETRICH, M
恶性疟疾患者的促凝血功能改变和血小板减少与寄生虫血症、血清肿瘤坏死因子-α（TNF-α）水平和临床严重程度相关。因此，肝素或乙酰水杨酸（阿萨），这是经常用来防止血栓形成和（在阿萨的情况下）控制发烧，可能是有益的。我们将97名恶性疟疾患者随机分为三组：33名患者皮下注射低剂量肝素，31名患者静脉注射阿萨，33名患者未接受任何药物。所有患者均接受了适当的抗寄生虫治疗。97例患者中有18例（7例接受肝素治疗，5例接受阿萨治疗，对照组6例）在入院时出现并发症。在治疗期间，升高的TNF-α和乳酸脱氢酶水平以及降低的血小板计数恢复到正常值。除肝素导致部分凝血活酶时间延长外，肝素或阿萨未影响任何实验室参数、寄生虫血症持续时间、发热清除或住院时间。因此，阿萨和肝素似乎不影响恶性疟疾的病程。因此，考虑到可能的副作用，不应建议将这些物质常规用于治疗人类疟疾。
Procoagulant alterations and thrombocytopenia in falciparum malaria correlate with parasitemia, serum levels of tumor necrosis factor-alpha (TNF-alpha), and clinical severity. Thus, heparin or acetylsalicylic acid (ASA), which are used frequently to prevent thrombosis and (in the case of ASA) to control fever, could be potentially beneficial. We randomized 97 patients with falciparum malaria into three groups: 33 patients received low-dose heparin subcutaneously, 31 received ASA intravenously, and 33 did not receive either drug. All patients received appropriate antiparasitic treatment. Eighteen of 97 patients (seven receiving heparin, five receiving ASA, and 6 in the control group) had complications upon admission. During therapy, elevated TNF-alpha and lactate dehydrogenase levels and decreased platelet counts returned to normal values. Except for a minimal partial thromboplastin time prolongation with heparin, heparin or ASA did not affect any laboratory parameter, duration of parasitemia, fever clearance, or the length of hospitalization. Thus, it appears that ASA and heparin do not influence the course of falciparum malaria. Hence, in view of possible side effects, these substances should not be recommended for routine use in the treatment of human malaria.