Loading dose of quinine in African children with cerebral malaria.
Loading dose of quinine in African children with cerebral malaria.
复制标题
非洲脑型疟疾儿童奎宁的负荷剂量。
DOI：
10.1016/s0035-9203(98)91032-x
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发表时间：
1998
影响因子：
2.2
通讯作者：
Gordeuk,VR
中科院分区：
文献类型：
--
作者：
vanderTorn,M;Thuma,PE;Mabeza,GF;Biemba,G;Moyo,VM;McLaren,CE;Brittenham,GM;Gordeuk,VR
大多数脑型疟疾死亡发生在入院后 48 小时内。由于在此期间治疗可能不充分，因此建议使用负荷剂量的奎宁。我们回顾了 113 名脑型疟疾儿童的临床和实验室数据，这些儿童在赞比亚农村地区的 Macha Mission 医院接受静脉注射奎宁（每 8 小时 10 毫克/公斤）治疗。 1990-1991年，有39名儿童没有接受负荷剂量的奎宁，而1992-1993年，有74名儿童接受了20毫克/公斤的负荷剂量。转铁蛋白饱和度反映的血清铁水平升高与较高的死亡率密切相关。奎宁的负荷剂量与更快地从昏迷中恢复以及增强寄生虫血症和发烧的清除有关。负荷剂量还与较低的死亡率和较高的血红蛋白水平的趋势相关，但这些差异在统计学上并不显着。
The majority of deaths from cerebral malaria occur within 48 h after admission to hospital. Because of the possibility of inadequate treatment within this period, the use of a loading dose of quinine has been proposed. We reviewed clinical and laboratory data for 113 children with cerebral malaria, who were treated with intravenous quinine, 10 mg/kg every 8 h, at Macha Mission Hospital in rural Zambia. In 1990–1991, 39 children were not given a loading dose of quinine while, in 1992–1993, 74 children received a loading dose of 20 mg/kg. Elevated serum iron levels, as reflected in transferrin saturation, were strongly associated with higher mortality. A loading dose of quinine was associated with faster recovery from coma and enhanced clearance of parasitaemia and fever. The loading dose was also associated with trends to lower mortality and higher haemoglobin levels, but these differences were not statistically significant.