直肠应用蒿甲醚与静脉注射奎宁治疗乌干达儿童脑疟疾的随机临床研究

作     者：Aceng J.R. Byarugaba J.S. Tumwine J.K. 黄卫东 

作者机构：Dept. of Paediatr. and Child Health Makerere Medical School PO Box 7072 Kampala Uganda 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2005年第1卷第7期

页      面：1-2页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：随机临床研究 蒿甲醚 意识恢复时间 退热时间 rectal clearance intravenous 经口 寄生虫学 坎帕拉 

摘      要：Objective: To compare the efficacy and safety of rectal artemether with intrav enous quinine in the treatment of cerebral malaria in children. Design: Randomis ed, single blind, clinical trial. Setting: Acute care unit at Mulago Hospital, U ganda’s national referral and teaching hospital in Kampala. Participants: 103 ch ildren aged 6 months to 5 years with cerebral malaria. Intervention: Patients we re randomised to either intravenous quinine or rectal artemether for seven days. Main outcome measures: Time to clearance of parasites and fever; time to regain ing consciousness, starting oral intake, and sitting unaided; and adverse effects. Results: The difference in parasitological and clinical outco mes between rectal artemether and intravenous quinine did not reach significance (parasite clearance time 54.2 (SD 33.6) hours v 55.0 (SD 24.3) hours, P = 0.90; fever clearance time 33.2 (SD 21.9) hours v 24.1(SD 18.9 hours, P = 0.08; time to regaining consciousness 30.1 (SD 24.1) hours v 22.67 (SD 18.5) hours, P = 0.1 0; time to starting oral intake 37.9 (SD 27.0) hours v 30.3 (SD 21.1) hours, P = 0.14). Mortality was higher in the quinine group than in the artemether group ( 10/52 v 6/51; relative risk 1.29, 95%confidence interval 0.84 to 2.01). No seri ous immediate adverse effects occurred. Conclusion: Rectal artemether is effecti ve and well tolerated and could be used as treatment for cerebral malaria.