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在东非,临床报道的恶性疟抗氯喹病例通常为Ⅰ级抗性,少数达到Ⅱ级抗性。本文报道了一例Ⅲ级抗性的病例。患者为52岁的亚洲妇女,出生于东非,1972年迁居英国前一直住在东非。1982年12月底去坦桑尼亚三兰港旅游,未采取防疟措施。她回英国后11天开始发热、寒战、头痛,2天后入院。体温39.5℃,无其他体征。血检查见恶性疟原虫滋养体,红细胞感染率为0.8%。给予氯喹1.5g,3天分服,在此期间病情加重,持续发热,脾肿大,并出现黄疸;血色素由16g降至9.5g/dl。于氯喹疗程后,红细胞感染率升到1.3%,许多红细胞感染2个或3个原虫。在第3天开始口服奎宁(10mg/kg),隔12小时1次,连服5天,接着服1剂“法西达”(周效磺胺1.5g,乙胺嘧啶
In East Africa, clinically reported cases of resistance to chloroquine of falciparum malaria are usually Grade I and a few reach Grade II resistance. This article reports a case of grade Ⅲ resistance. The 52-year-old Asian woman, born in East Africa, lived in East Africa before moving to England in 1972. Travel to Silan Port, Tanzania, by the end of December 1982, without malaria measures. She returned to England after 11 days fever, chills, headache, 2 days after admission. Body temperature 39.5 ℃, no other signs. Blood tests showed P. falciparum trophozoites, red blood cell infection rate was 0.8%. Give chloroquine 1.5g, 3 days uniforms, exacerbations during this period, continued fever, splenomegaly, and jaundice; hemoglobin decreased from 16g to 9.5g / dl. After chloroquine treatment, the rate of erythrocyte infection rose to 1.3%, with many erythrocytes infecting 2 or 3 protozoa. On the third day, oral quinine (10 mg / kg) was given once every 12 hours for 5 days followed by 1 dose of faxacid