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本文报道了用别嘌呤醇(Allopurinol)治疗的2例病人:第一例是28岁的男性吉普赛人。血清内人体免疫缺陷病毒(HIV)阳性。根据其发热、肝脾肿大及各类血细胞减少,诊断为内脏利什曼病。CD4~+细胞计数为0.0122×10~9/L,骨髓和肝穿刺查见利什曼原虫,用NNN基培养阳性。开始用60mg/kg的葡甲胺锑剂治疗15天,再经21天的第2疗程后,骨髓培养阴性。几个月后,临床复发,骨髓培养阳性,CD4~+细胞计数为0.054×10~9/L,于是重新治疗,在第4疗程的12天后,骨髓培养仍阳性,随后开始每天给以20mg/kg的别嘌呤醇3次,以后骨髓3次培养均阴性。病人的T4细胞计数未超过0.05×10~9/L。
This article reports 2 patients treated with allopurinol: the first is a 28-year-old male gypsian. Serum human immunodeficiency virus (HIV) positive. According to its fever, hepatosplenomegaly and various types of cytopenias, diagnosis of visceral leishmaniasis. CD4 ~ + cell count was 0.0122 × 10 ~ 9 / L, Leishmania was detected in bone marrow and liver puncture, and positive with NNN culture. Start with 60mg / kg meglumine antimony agent for 15 days, then after 21 days of the second course of bone marrow culture negative. A few months later, clinical relapse, positive bone marrow culture, CD4 ~ + cell count was 0.054 × 10 ~ 9 / L, so re-treatment in the first four courses of treatment after 12 days, bone marrow culture was still positive, kg of allopurinol 3 times, after 3 times the bone marrow were negative. The patient’s T4 cell count did not exceed 0.05 × 10 ~ 9 / L.