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Infection：2001-2017年埃塞俄比亚内脏利什曼病的治疗结果如何？

2018-11-29 MedSci MedSci原创

内脏利什曼病
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<p class="MsoNormal" style="margin-bottom:0cm;margin-bottom:.0001pt;line-height: normal">在撒哈拉以南非洲地区，埃塞俄比亚的内脏利什曼病<span lang="EN-CA" style="font-size:10.0pt;font-family:"Times New Roman",&quo

在撒哈拉以南非洲地区，埃塞俄比亚的内脏利什曼病(VL)病例数量仅次于苏丹。然而，尽管在该国VL疾病负担沉重，但治疗结果尚缺乏全面的数据。因此，本目标是对此进行系统和荟萃分析，进而从埃塞俄比亚现有文献中获得更有力的关于VL治疗结果的证据。

研究人员最终分析共包括15项研究。治疗结束时，整体治疗成功率为82.6%。在6个月的随访中，总的治疗成功率为72.2%。使用锑葡酸钠(SSG)治疗的患者，治疗结束和6个月随访的治疗成功率分别为81.5%和80.7%。多剂量的脂质体-两性霉素B (L-AMB)在治疗结束和6个月随访时治疗成功率分别为96.7和71% 100%。SSG与paromomycin (PM)的联合治疗在治疗结束时的成功率高达90.1%。6个月随访发现，HIV感染者死亡率较高(优势比= 4.77,95% CI: 1.30 17.43, P = 0.009)。

研究显示，单SSG治疗VL的疗效低于SSG与PM和L-AMB的多剂量治疗的联合治疗。SSG联合PM治疗成功率高，治疗时间短。因此，SSG与PM联合使用应优先于SSG单药治疗。多剂量的L-AMB显示出很好的疗效，特别是在有并发症、严重疾病、艾滋病联合感染和对药物不良反应不耐的患者中。感染艾滋病毒的人群比阴性对照人群预后差。

原始出处：

Eyob Alemayehu Gebreyohannes,Treatment outcomes of visceral leishmaniasis in Ethiopia from 2001 to 2017

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    2019-09-24 jiangfeng5067

    #利什曼病#

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    2019-01-25 yanjie6253_56072842

    #埃塞俄比亚#

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    2018-12-01 lidong44

    #Infection#

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    2018-12-01 jiadan198786

    #治疗结果#

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利什曼原虫复合体是人畜共患和内脏利什曼病（VL）的一类重要病原体，56个国家受其影响并导致330万残疾调整生命年和20,000–40,000 死亡。目前尚无可用的预防性疫苗，而且治疗药物太贵并可能有显著的毒性问题，而在南亚的VL发病率下降的同时，并未发现有效媒介控制作用的证据。