Abstract:

Objective  To evaluate the clinical efficacies and safety of praziquantel for treatment of advanced schistosomal liver fibrosis. Methods  A total of 60 advanced schistosomiasis patients with hepatic fibrosis were randomly assigned to two groups. Patients in the control group received conventional liver protective medication, whereas those in the treatment group were given additional praziquantel in dose of 60 mg/kg, once a month on the conventional therapy protocol basis. Color Doppler ultrasonography was performed to measure the inner diameter of portal vein, spleen thickness and the width of splenic vein, and the serum concentrations of hyaluronic acid (HA), laminin (LN), type Ⅳ collagen (C-Ⅳ), procollagen Ⅲ propeptide (PⅢP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined 6 months before invention and after 6 months of medication to evaluate the therapeutic efficacies of praziquantel. The adverse reactions were also observed within 24h of praziquantel administration. Results  There were no significant differences in the inner diameter of portal vein, spleen thickness and the width of splenic vein in the control group before and after treatment (all P values >0.05), whereas those index were significantly decreased in the treatment group after 6 months of medication(all P values < 0.05). Serum AST and ALT activities were declined in patients in the two groups, yet the decline was significant in treatment group. The control group had no significant difference regarding serum HA, LN, C-IV and PⅢP concentrations(all P values >0.05), yet the difference was significant for the treatment group (all P values <0.05). Adverse reactions occurred in patients treated with praziquantel, including nausea in 3 cases and dizziness in 1, and symptoms disappeared within 2 days. Conclusion  Praziquantel is effective and safe agent for patients with schistosome-induced hepatic fibrosis, and worthy of wider clinical use.

Key words: Advanced schistosomiasis, Hepatic fibrosis, Praziquantel, Therapeutic efficacy, Safety