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目的探讨青蒿琥酯(Art)联合阿苯达唑脂质体(L-Alb)预防小鼠囊型包虫病术后复发的作用,寻找有效药物辅助手术治疗。方法实验小鼠分为Art组(100mg/kg·d,20只)、L-Alb组(75mg/kg·d,20只)、联合用药组(剂量同前,20只)和生理盐水组(等量,20只),以上各组再分成继续治疗组(10只)和停药组(10只),另设空白对照组(10只)和免疫对照组(10只)。小鼠用人包虫囊液进行免疫,使体内IgG抗体高于空白对照小鼠,并模拟术前用药,于接种前10d给予上述剂量药物;用羊源肝包虫头节接种小鼠,2000个/只,20d后继续治疗(停药组停止治疗),3个月后观察小鼠的感染率、囊湿重、抑制率和脾脏指数;取囊肿,HE染色后镜下观察组织结构的改变;取血,分离血清,ELISA法检测IgG4、IgE、TNF-α的变化。结果药物治疗3个月后,Art组、L-Alb组、联合用药组包虫感染率分别为77.8%、80.0%和77.8%,与生理盐水组的77.8%比较,差异无统计学意义(P>0.05);囊湿重抑制率分别为68.43%、73.32%和80.37%(P<0.05),接种前联合用药组抑制率为24.00%;脾脏指数分别为(4.7463±0.8321)%、(4.6374±0.7949)%、(4.1218±0.7055)%,生理盐水组为(5.7830±0.5012)%(P<0.01)。病理观察各组小鼠囊肿均有不同程度的破坏,其中联合用药组以中-重度破坏为主,其他用药组以轻-中度破坏为主。药物治疗组IgG4、IgE、TNF-α含量与生理盐水组相比均下降(P<0.01)。结论 Art联合L-Alb治疗能抑制复发包虫的生长,但抑制包虫复发的作用欠佳。
Objective To investigate the effect of Artesunate (Art) combined with albendazole liposome (L-Alb) on the prevention of postoperative recurrence of cystic echinococcosis in mice and to find an effective drug-assisted surgical treatment. Methods The experimental mice were divided into Art group (n = 20), L-Alb group (n = 20), Artemia group (20 mg / (N = 20). The above groups were further divided into continuous treatment group (n = 10) and withdrawal group (n = 10), and blank control group (n = 10) and immune control group (n = 10). The mice were immunized with human hydatid cyst fluid to make the body IgG antibody higher than the blank control mice and simulate the preoperative medication and the above doses were given 10 days before inoculation; / Only, continue treatment after 20d (discontinuation of treatment group), 3 months after the mice were observed infection rate, wet weight, inhibition rate and spleen index; take cyst, HE staining microscopy changes in organizational structure; Blood was collected and serum was separated. The changes of IgG4, IgE and TNF-α were detected by ELISA. Results The infection rates of hydatid disease were 77.8%, 80.0% and 77.8% in Art group, L-Alb group and combination group at 3 months after drug treatment, respectively, with no significant difference compared with 77.8% in saline group (P > 0.05). The inhibition rates of wet weight were 68.43%, 73.32% and 80.37% respectively (P <0.05), and the inhibition rates were 24.00% and 4.7463 ± 0.8321%, 4.6374 ± 0.7949%, 4.1218 ± 0.7055%, and 5.7830 ± 0.5012% respectively in the saline group (P <0.01). Pathological observation Cysts of mice in each group have varying degrees of damage, including combination therapy group to moderate to severe damage-based, the other treatment group with mild to moderate destruction. The levels of IgG4, IgE and TNF-α in the drug treatment group were significantly lower than those in the saline group (P <0.01). Conclusion Art combined with L-Alb treatment can inhibit the growth of hydatid disease, but the inhibition of hydatid disease recurrence is not good.