目的监测云南省盈江县中缅边境恶性疟原虫对氯喹、哌喹的体外敏感性,了解两种抗疟药有无交叉耐药。方法选取2007—2009年当地病人体内的恶性疟原虫,体外培养成活共28株,在体外进行对氯喹、哌喹的半效抑虫浓度(IC50)值测定;并对疟原虫的Pfert基因片段扩增,测序,比对。结果28株恶性疟原虫株体外氯喹的IC50值为(463.9±256.0)nm;哌喹的IC50值为(9.0±6.7nm)和野生株3D7相比,均有显著性差异(P〈0.05)。28株(100%)恶性疟原虫对氯喹均耐药株;5/28(16.1%)的疟原虫对哌喹耐药;7/28(21.4%)的疟原虫对哌喹敏感。28株(100%)疟原虫的Pfert基因发现均有和氯喹耐药相关的76T变异。应用Pearson线性相关分析发现CQ和PPQ间存在又抗药性(P〈0.001)。结论云南省盈江县中缅边境的恶性疟原虫对氯喹、哌喹耐药的情况严峻,尤其是氯喹。
Objective To evaluate susceptibility in vitro of plasmodium falciparum to chloroquine and piperaquine on the China -Myanmar border at Yingjiang County of Yunnan Province. Methods Twenty-eight parasites collected from local patients were cultured in vitro, and measured drug susceptibilities in chloroquine ( CQ ) and piperaquine { PQ }, then we calculated the 50% inhibitory concentrations (IC50). The Pfcrt gene of plasmodium faleiparum were sequenced by polymerase chain reaction and (PCR) by direct sequencing methods. Results The IC50s of CQ in patients parasites was 463.9±256.0nm; PQ was 9.0±6. 7nm, and both higher than 3D7 (P〈0.05). In all samples the rates of ehloroquine-resistant were 100% ; The rates of pipera- quine-resistant were 16.1% ; The susceptibility rates of piperaquine were 21.4% ; The rates of mutation of 76T were 100%. By Pearson correlation analysis, we found there had cross-resistance between CQ and PQ. Conclusion Plasmodium falciparum had high resistance to CQ and PQ at Yingjiang County in Yunnan Province.