关键词: 细粒棘球蚴, 术后复发, 阿苯达唑脂质体, 槐耳浸膏

Abstract: Objective To explore the effect of Huai-Er fungus extract (HEF) and liposome albendazole (L-ABZ)on the hepatic infection of Echinococcus granulosus(Eg) in mice，and understand the influence of improved host immunity on postoperative recurrence. Methods Female Kunming mice were immuned by intraperitoneal injection Eg cyst fluid from sheep，IgG positive mice were divided into drug treatment groups(A，B and C) and control group(D). Mice in group A were administered by gavage with single L-ABZ(75 mg/kg)，group B with single HEF(15 000 mg/kg)，and group C with combination therapy (L-ABZ 75 mg/kg plus HEF 15 000 mg/kg)，once every two days for one week. The prostoscoleces were treated with balanced solution for 20 minute and inoculated in the liver by open abdomen of the anesthetized mice. Imitating to an “open sub-adventitial total exocystectomy”， prostoscoleces outside the cyst led to reinfection. 72 hours later，groups A，B and C were re-treated for a month. Mice in group D were given with distilled water (0.3 ml per mouse). Group E was set as blank control (n=8). Another 120 IgG positive mice were divided as groups F，G，H and I，and treated in parallel with the groups A，B，C and D respectively；these mice were inoculated with prostoscoleces which were treated in advance with 75% alcohol， 20% hypertonic saline，L-ABZ and PBS for 20 min respectively. In 3 months after infection，all the mice were sacrificed to evaluate the efficacy，which covered infection rate，pathological change，spleen index，level of IgG and IgE，CD4+ and CD8⁺ cells. Results The recurrence rate in group C (5.7%) was lower than that of groups A (17.1%) and B (24.2%)，with hydatid cysts in white colour and nodular，showing degeneration of the germinal and laminated layers. Groups A，B and C showed lower spleen index(A：3.84±0.86，B：3.95±1.01，and C：3.27±0.52)，and lower IgE level (A：0.06±0.08，B：0.07±0.08 and C：0.03±0.03) than group D (5.46±0.52 and 0.20±0.02，respectively)(P＜0.05)，especially in group C；and also lower CD8⁺ in groups A (16.61±3.89)，B(18.18±3.90) and C(15.38±2.63) than group D (32.90±4.71)(P＜0.05)，but higher CD4⁺/CD8⁺ in groups A(3.21±0.70)，B(3.05±0.66) and C (3.53±0.57) than group D (1.57±0.26)(P<0.05)，especially in group C. The infection rate of mice in group F，G and H was 0，0 and 23.1% respectively，and that of group I，31.2%（P＜0.01）. Conclusion The combination of HEF and L-ABZ considerably improves the immunity of the hosts and HEF may have a synergetic action to L-ABZ in reducing the recurrence of “sub-adventitial total exocystectomy”. 75% alcohol and 20% hypertonic saline show better effect of inactivating prostoscoleces than L-ABZ in surgical operation.

Key words: Echinococcus granulous, Recurrence, Liposome albendazole, Huai-Er fungus extract