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目的观察吡喹酮(PQT)对疑似脑囊尾蚴病患者的诊疗作用。方法先采用间接血凝试验(IHA)和酶联免疫吸附试验(ELISA)检测疑似脑囊尾蚴病患者血清和脑脊液中的抗体,并采用夹心ELISA法检测患者血清和脑脊液中的循环抗原,再应用大剂量PQT[50 mg/(kg.d)×12 d]对疑似脑囊尾蚴病患者进行诊断性治疗。结果93例疑似脑囊尾蚴病患者诊断性治疗后有38例确诊患脑囊尾蚴病,42例基本确诊患其他脑部疾患,13例仍诊断不明。38例脑囊尾蚴病患者有27例服吡喹酮后出现杀虫反应,其中治疗后有17例患者复查脑CT或MR I,结果显示病灶缩小、周围水肿吸收或消失;有2例患者复查脑CT显示病灶增多,且呈囊性影像学表现;另11例确诊为脑囊尾蚴病的患者服药期间未出现杀虫反应,根据治疗后复查CT或MR I,病灶较治疗前吸收或消失而确诊。确诊的38例脑囊尾蚴病患者再经过1~2个疗程抗囊尾蚴治疗后临床症状消失,其中31例患者复查脑CT,病灶完全吸收者26例,病灶出现钙化者5例。结论大剂量吡喹酮对疑似脑囊尾蚴病患者具有较好的诊疗作用。
Objective To observe the clinic effect of praziquantel (PQT) on patients with suspected cysticercosis. Methods Anti-bodies of serum and cerebrospinal fluid of patients with suspected cysticercosis were detected by indirect hemagglutination test (IHA) and enzyme-linked immunosorbent assay (ELISA), and the circulating antigens in serum and cerebrospinal fluid were detected by sandwich ELISA. High-dose PQT [50 mg / (kg.d) × 12 d] for the diagnosis of suspected cysticercosis patients. Results After the diagnosis of 93 cases of suspected cysticercosis, 38 cases were diagnosed as cerebral cysticercosis, 42 cases were diagnosed with other brain diseases, and 13 cases were still unknown. Thirty-seven patients with cysticercosis were treated with praziquantel. After treatment, 17 patients were retrospectively reviewed with CT or MR imaging. The results showed that the lesion lessened and the surrounding edema absorbed or disappeared. Two patients were reviewed Brain CT showed increased lesions, and showed cystic imaging performance; the other 11 patients diagnosed as cerebral cysticercosis patients did not appear during the pesticide insecticidal response, according to the post-treatment review CT or MR I lesions than before treatment absorbed or disappeared Confirmed. Among the 38 patients diagnosed with cysticercosis, the clinical symptoms disappeared after 1 or 2 courses of treatment with cysticercus. Among them, 31 cases had rechecked brain CT, 26 cases had completely absorbed lesion, and 5 cases showed calcification. Conclusion High-dose praziquantel has a good diagnosis and treatment effect on patients with suspected cerebral cysticercosis.