| 梅家模,李志宏,章承锋,徐建民,胡强.强力霉素对钩端螺旋体病的预防效果研究[J].Chinese journal of Epidemiology,2006,27(7):610-613 |
| 强力霉素对钩端螺旋体病的预防效果研究 |
| Serial studies on doxycycline prophylaxis against leptospirosis |
| Received:February 17, 2006 |
| DOI： |
| KeyWord: 钩端螺旋体病 强力霉素 预防药 |
| English Key Word: Leptospirosis Doxycycline Prophylactic |
| FundProject:卫生部科学研究基金资助项目(WKJ-1999-01-01) |
| Author Name | Affiliation | | MEI Jia-mo | Jiangxi Provincial Center for Disease Prevention and Control, Nanchang 330029, China | | LI Zhi-hong | Jiangxi Provincial Center for Disease Prevention and Control, Nanchang 330029, China | | ZHANG Cheng-feng | Jiangxi Provincial Center for Disease Prevention and Control, Nanchang 330029, China | | XU Jian-min | Jiangxi Provincial Center for Disease Prevention and Control, Nanchang 330029, China | | HU Qiang | Jiangxi Provincial Center for Disease Prevention and Control, Nanchang 330029, China |
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| Abstract: |
| 目的探讨强力霉索对钩端螺旋体(钩体)病的预防效果。方法分别在28℃和37℃培养进行抑杀效果观察。将钩体接种的金黄地鼠分为直接感染组、感染前给药组、感染后给药组及空白对照组,分别观察各组实验动物的临床表现、体温变化、心脏血和尿培养结果及肝、肾组织病理学改变;选定钩体病流行区,采用双盲法,将人群分为服用强力霉素组和安慰剂组,分别观察两组的发病情况和服用强力霉素后的副反应情况。结果在28℃条件下强力霉素对钩体具有较强的抑杀效果,对15群15型钩体最小抑杀菌浓度分别为2μml和4μg/ml;模拟人体体温(37℃培养)条件下强力霉素含量为0．25μg/ml时,对钩体仍有较好的杀灭效果,含量0．125μg/ml时,仍有抑制作用;动物实验观察到直接感染组和感染前给药组部分金黄地鼠出现血尿、尿色金黄等钩体病临床表现;肝、肾组织病理学改变,其病变程度以直接感染组最为明显,感染前给药组次之,感染后给药组最轻;现场人群服用强力霉素组无病例发生,服用安慰剂组出现5例患者,两组间差异有统计学意义,服用强力霉素组仅1例出现轻微胃肠道刺激症状。结论通过抑杀试验、动物实验和现场人群投服实验等系列研究,均证实了强力霉素对钩体病有较好的预防效果,可以作为钩体病流行和暴发的应急预防措施。 |
| English Abstract: |
| Objective To study the efficacy of doxycycline prophylaxis against leptospirosis, a serial of studies including laboratory, animal and field trials were conducted. Methods An effectiveness trial of doxycycline in inhibiting Leptospira was conducted in the laboratory with temperature set at 28℃and 37℃respectively, simulating the temperatures on leptospira-friendly and human body. Goladen hamsters infected by Leptospira were divided into the groups as directly-affected, dosed-before-affected, dosed-after-affected and placebo, to observe the symptoms, temperatures, culture Results of heart blood and urine as well as pathological changes of liver and kidney. In the endemic areas, a double-blinded, palcebo-controlled field trial was set up to assess the attack rate and the side-effects after administered doxycycline. Results A significant inhibitive effect of doxycycline on group 15 type 15 was found in the leptospira-friendly group, with concentration at 2μg/ml and 4μg/ml,while in 37℃at 0.25μg/ml and 0.125μg/ml. In the animal trial,blood or golden-colored urine occurred in both directly-affected group and the dosed-before-affected group. The order of pathological changes appeared as:the group directly affected＞the group dosed before affected＞the group dosed after affected. In the field trial,no case occurred in the doxycycline group while 5 cases were identified in the placebo group. There was a significant difference between these two groups with only one case in the doxycycline group having alimentary irritation. Conclusion The Results of the serial studies from laboratory, animal and field showed preferable outcomes of doxycycline prophylaxis against leptospirosis,suggesting its role in emergent prophylaxis during the epidemics and outbreaks. |
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