Praziquantel treatment in trematode and cestode infections: an update.
Praziquantel treatment in trematode and cestode infections: an update.
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DOI：
10.3947/ic.2013.45.1.32
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发表时间：
2013-03
影响因子：
4.2
通讯作者：
Chai JY
中科院分区：
文献类型：
--
作者：
Chai JY
简要回顾了吡喹酮用于治疗人类吸虫和寄生虫感染的现状和新出现的问题。自1975年吡喹酮首次作为一种广谱驱虫药被引入以来，已经发表了无数文章，描述了吡喹酮在治疗大多数人类感染的虫和绦虫方面的成功应用。目标吸虫病和囊虫病包括血吸虫病、支睾吸虫病和阿片吸虫病、肺吸虫病、异孢子虫病、棘孔虫病、筋膜虫病、新双口虫病、裸眼虫病、绦虫病、棘孔虫病、膜虫病和囊虫病。然而，肝片形吸虫和巨型片形吸虫感染对吡喹酮是难治的，因此必须使用替代药物三氯苯达唑。此外，吡喹酮不能成功地治疗幼虫寄生虫感染，特别是包虫病和斯巴达病。吡喹酮的确切作用机制尚不清楚。吡喹酮治疗也出现了新的问题，其中包括在治疗曼氏血吸虫和可能的日本血吸虫时出现耐药性，以及对吡喹酮治疗的过敏或超敏反应。为了应对和克服这些问题，正在尝试联合使用药物，即吡喹酮和其他新引入的化合物，如三氯苄达唑、青蒿素和三苯二胺。
Status and emerging issues in the use of praziquantel for treatment of human trematode and cestode infections are briefly reviewed. Since praziquantel was first introduced as a broadspectrum anthelmintic in 1975, innumerable articles describing its successful use in the treatment of the majority of human-infecting trematodes and cestodes have been published. The target trematode and cestode diseases include schistosomiasis, clonorchiasis and opisthorchiasis, paragonimiasis, heterophyidiasis, echinostomiasis, fasciolopsiasis, neodiplostomiasis, gymnophalloidiasis, taeniases, diphyllobothriasis, hymenolepiasis, and cysticercosis. However, Fasciola hepatica and Fasciola gigantica infections are refractory to praziquantel, for which triclabendazole, an alternative drug, is necessary. In addition, larval cestode infections, particularly hydatid disease and sparganosis, are not successfully treated by praziquantel. The precise mechanism of action of praziquantel is still poorly understood. There are also emerging problems with praziquantel treatment, which include the appearance of drug resistance in the treatment of Schistosoma mansoni and possibly Schistosoma japonicum, along with allergic or hypersensitivity reactions against praziquantel treatment. To cope with and overcome these problems, combined use of drugs, i.e., praziquantel and other newly introduced compounds such as triclabendazole, artemisinins, and tribendimidine, is being tried.