Duplex Doppler sonographic assessment of the effects of diethylcarbamazine and albendazole therapy on adult filarial worms and adjacent host tissues in bancroftian filariasis
Duplex Doppler sonographic assessment of the effects of diethylcarbamazine and albendazole therapy on adult filarial worms and adjacent host tissues in bancroftian filariasis
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DOI：
10.4269/ajtmh.2004.71.471
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发表时间：
2004-10-01
影响因子：
3.3
通讯作者：
Weil, GJ
中科院分区：
文献类型：
--
作者：
Hussein, O;El Setouhy, M;Weil, GJ
我们使用双功能多普勒超声来评估乙胺嗪和阿苯达唑治疗（DEC/ALB）对体内成人班氏丝虫的影响。该研究在临床正常的埃及成年人中进行，血液微丝蚴计数> 80/mL。治疗前，在36名男性中的28名（78%）扩张的阴囊淋巴管和22名女性中的5名（23%）近端四肢中观察到活动蠕虫。大多数虫巢在给药后几个月内被灭活（12个月时为90%）。治疗后，循环中的丝虫抗原水平（活蠕虫的标志物）也急剧下降。有些男性在接受治疗前超声可检测到阴囊内钙化和/或不可触及的鞘膜积液。多数病例治疗后出现新的鞘膜积液和阴囊内钙化。然而，其中大多数是短暂的，没有临床意义。治疗后24个月鞘膜积液和阴囊内钙化的患病率与治疗前基本相同。这些结果表明DEC/ALB对W. bancrofti。他们还表明，宿主对垂死蠕虫的反应在丝虫性水囊肿的发病机制中很重要。
We used duplex Doppler sonography to assess effects of diethylcarbamazine and albendazole therapy (DEC/ALB) on adult Wuchereria bancrofti in vivo. The study was performed in clinically normal Egyptian adults with blood microfilaria counts > 80/mL. Motile adult worms were observed before treatment in dilated scrotal lymphatic vessels in 28 of 36 men (78%) and over the proximal extremities in 5 of 22 women (23%). Most worm nests were inactivated in the months following treatment (90% at 12 months). Circulating filarial antigen levels (a marker for living adult worms) also fell dramatically following treatment. Some men had intrascrotal calcifications and/or non-palpable hydroceles detectable by ultrasound before they were treated. New hydroceles and intrascrotal calcifications appeared after treatment in many cases. However, most of these were transient and of no clinical significance. Prevelance rates for hydrocele and intrascrotal calcifications 24 months after treatment were essentially the same as those prior to treatment. These results show that DEC/ALB is highly active against adult W. bancrofti. They also suggest that host responses to dying adult worms are important in the pathogenesis of filarial hydroceles.