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目的 : 观察鄱阳湖血吸虫病流行区抗洪抢险人群用蒿甲醚口服预防血吸虫感染的效果。方法 :1996年 7月中旬至 8月中旬 ,鄱阳湖因暴雨水位提高 ,我们选择发生险情的赭堤和浆汤堤为试点 ,在参加抗洪抢险人员上堤后 4 8h内 ,用间接血凝试验、酶联免疫吸附试验和检测循环抗原法进行筛查 ,全部阴性者随机分为蒿甲醚组和对照组。蒿甲醚组人群于接触疫水 11- 15d内服1剂蒿甲醚 6mg/ kg,以后持续接触疫水 ,间隔 15d再服 1剂 ,停止接触疫水后 7- 15d则继服 1次。对照组于相同时间内服安慰剂 (淀粉 ) 6mg/ kg。两组人群于末次服药后 4 0 - 50 d作粪检 ,考核预防效果。结果 :在赭堤试点中 ,人群接触疫水约 30 d,蒿甲醚组完成 3次服药和粪检的 99例 ,血吸虫卵阳性者 4例 ,无急性血吸虫病发生 ,对照组粪检 110例 ,虫卵阳性者 4 4例 ,发生急性血吸虫病者 2 9例。在浆汤试点中 ,人群接触疫水 1d,蒿甲醚组完成 2次服药和粪检的 10 3例 ,无虫卵阳性者 ,对照组粪检 10 2例 ,虫卵阳性 4例。未见蒿甲醚有何不良反应。结论 :在鄱阳湖血吸虫病流行区 ,蒿甲醚对抗洪抢险人群有很好的预防血吸虫病的效果。
Objective: To observe the effect of oral administration of artemether to prevent schistosomiasis in flood-fighting and emergency population of schistosomiasis endemic areas in Poyang Lake. Methods: From mid-July to mid-August 1996, due to the increase of stormwater level in Poyang Lake, we chose the octagonal embankment and the ditch embankment where the danger occurred. During the period of 48 h after participating in the flood embankment, the indirect hemagglutination test , Enzyme-linked immunosorbent assay and detection of circulating antigen method for screening, all were randomly divided into artemether group and control group. In the artemether group, one dose of artemether 6mg / kg was administered orally within 11-15 days after exposure to the contaminated water, and then continuously exposed to the contaminated water for 15 days at intervals of 1 d. The control group received placebo (starch) 6 mg / kg at the same time. Two groups of people in the last dose of 40 ~ 50 d for stool, assessment of prevention. Results: In the trial of octagonal embankment, the crowd contacted the epidemic water for about 30 days. The artemisinin group completed 99 cases of three doses and dung seizures, 4 cases of schistosome egg-positive, and no acute schistosomiasis. The control group had 110 cases 44 cases of egg-positive and 29 cases of acute schistosomiasis. In the trial of slurry soup, the population exposed to water 1d, artemether group completed 2 times medication and manure seized 103 cases, no egg-positive, the control group of 102 cases of feces, egg-positive in 4 cases. No adverse reactions have been seen artemether. Conclusion: In the endemic area of schistosomiasis in Poyang Lake, artemether can prevent schistosomiasis well in flood-fighting rescue population.