青蒿素及其衍生物治疗疟疾的研究进展

doi:10.12140/j.issn.1000-7423.2021.03.016

摘要/Abstract

摘要：

青蒿素是一种安全性良好的抗疟药物,以青蒿素为基础的联合用药已被世界卫生组织推荐为治疗恶性疟的一线方法。然而,青蒿素在治疗疟疾的过程中已产生耐药性,并已逐渐成为疟疾控制的主要威胁。青蒿素类药物以其速效、低毒等特点备受关注。近年来,青蒿素及其衍生物的研究和临床应用正在不断开展与深入,本文对近年来青蒿素类药物的抗疟机制、耐药现象及机制、临床应用等方面的研究进展进行了综述,以期对青蒿素及其衍生物的进一步研究和应用提供有价值的参考。

关键词: 青蒿素, 青蒿素类衍生物, 青蒿素耐药性, 疟疾

Abstract:

Artemisinin is a safe antimalarial drug. Artemisinin-based drug combinations have been recommended by the World Health Organization as the first-line treatment for falciparum malaria. However, artemisinin resistance is emerging in the treatment of malaria, and has gradually become a major threat to malaria control. Artemisinin drugs have attracted much attention due to the quick effect and low toxicity. In recent years, research and clinical application of artemisinin and its derivatives have been continuously carried out in depth. This paper reviews the antimalarial mechanism, drug resistance phenomenon and mechanism and clinical application of artemisinin drugs, in order to provide valuable reference of further research and application of artemisinin and its derivatives.

Key words: Artemisinin, Artemisinin derivatives, Artemisinin resistance, Malaria

中图分类号:

R531.3

杨博, 孙毅凡, 雷瑶, 程洋. 青蒿素及其衍生物治疗疟疾的研究进展[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(3): 393-402.

YANG Bo, SUN Yi-fan, LEI Yao, CHENG Yang. Research progress on the treatment of malaria with artemisinin and its derivatives[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2021, 39(3): 393-402.

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试验药物	试验时间、地点	试验对象	试验结果	参考文献
AS + SP;AL	2009年11月至2013年3月;也门	432名6个月至75岁的恶性疟患者	AS+SP的PCR校正治愈率为98%和100%,AL的PCR校正治愈率均为100%	[59]
PND-AS;DHA + PPQ	2011年10月至2016年2月;西非	4 710名6个月及以上的成人和儿童恶性疟患者	在第28天和第42天,所有研究方法对经PCR调整的人群总有效率均超过99%	[60]
AL;DHA + PPQ	2012年1月至2013年3月;乌干达东部	150名患严重疟疾的儿童	第7天毛细血管哌喹浓度低（<57 ng/ml）的儿童治疗失败的风险是浓度高（> 57 ng/ml）的儿童的两倍;建议在儿童中采用更高剂量的DHA+PPQ	[61]
DHA + PPQ;DHA-PPQ + MQ;AS + MQ;AL;AL + AQ	2015年8月至2018年2月;大湄公河次区域国家及孟加拉国、印度、刚果民主共和国	1 100例2至65岁感染恶性疟原虫者	DHA-PPQ+MQ组在3个地区中第42天的 PCR校正有效率分别为98%、91%、96%;AL+AQ组第42天%）	[63]
MB-As-AQ;PQ-As-AQ	2016年7月至11月;布基纳法索	100名6至59个月的单纯恶性疟患儿	MB组的疟原虫清除率明显更高,配子体密度低于PQ组	[64]
AS + AQ;AL	2017年10月至2018年3月;加蓬兰巴莱市	100名6个月至12岁的儿童	AL和AS+AQ第28天的PCR校正治愈率分别为97%和95%	[62]