Hyperparasitemia and blood exchange transfusion for treatment of children with falciparum malaria
Hyperparasitemia and blood exchange transfusion for treatment of children with falciparum malaria
复制标题
DOI：
10.1086/513926
复制
发表时间：
1998-04-01
影响因子：
11.8
通讯作者：
Kremsner, PG
中科院分区：
文献类型：
--
作者：
Mordmüller, B;Kremsner, PG
大量的病例报告和小型调查支持血液交换输血作为恶性疟原虫疟疾病例中高寄生虫血症的治疗方法，尽管从未进行过前瞻性和随机研究。我们报告了113例前瞻性入组的加蓬兰巴内儿童，他们的红细胞寄生率超过10%，仅用化疗治疗。所有86例患者的寄生虫血症作为唯一的并发症恢复顺利。在27名有其他并发症的患者中，高达81%的寄生虫血症水平对单独化疗反应良好。两名脑型疟疾患者死亡，他们也有其他并发症，因此预后不良。高寄生虫血症本身可能对疟疾致命事件的发展很重要，但建议进行危险，昂贵和劳动密集型的程序，如血液交换输血治疗应基于大量的临床研究，特别是在疟疾是一个主要健康问题的地区。
A substantial number of reports of cases and small investigations support blood exchange transfusion as a therapy for hyperparasitemia in cases of Plasmodium falciparum malaria, although a prospective and randomized study has never been undertaken, We report on 113 prospectively enrolled children in Lambarene, Gabon, who had more than 10% parasitized erythrocytes and were treated with chemotherapy alone. All 86 patients with hyperparasitemia as the sole complication recovered uneventfully. Among the 27 patients who had additional complications, parasitemia levels as high as 81% responded well to chemotherapy alone. Two patients with cerebral malaria, who also had other complications and hence a poor prognosis, died. Hyperparasitemia itself might be important for the development of a fatal event in malaria, but a recommendation to perform a dangerous, expensive, and labor-intensive procedure such as blood exchange transfusion for its treatment should be based on substantial clinical research, especially in areas where malaria is a major health problem.