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首页> 美国政府科技报告 >High-Dose Dexamethasone in Quinine-Treated Patients with Cerebral Malaria: A Double-Blind, Placebo-Controlled Trial
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High-Dose Dexamethasone in Quinine-Treated Patients with Cerebral Malaria: A Double-Blind, Placebo-Controlled Trial

机译：奎宁治疗脑疟疾患者的高剂量地塞米松：双盲，安慰剂对照试验

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Cerebral malaria is the most common life-threatening complication of malaria, a disease thought to be responsible for more than a million deaths per year. Even with appropriate antimalarial therapy in hospitals with modern intensive-care facilities, mortality in comatose patients with cerebral malaria is often 15%-25% and may reach 50%. We compared placebo and dexamethasone in a double-blind trial involving 10 stuporous and 28 comatose patients with cerebral malaria. Patients were 18 mo to 42 y of age (geometric mean, 10.2y), and the 19 patients in each group were comparable on admission. All patients received intravenous quinine therapy. Four patients (21%) in each group died. There were no significant differences between the placebo- and dexamethasone-treated groups in time until patients became afebrile, the level of consciousness became normal, or parasitemia was cleared or in the incidence of complications. Coma or hyperparasitemia at the time of admission and hypoglycemia at any time during hospitalization were significantly correlated with a fatal outcome, which was not improved by using dexamethasone. We conclude that high-dose dexamethasone is not indicated for treating cerebral malaria. Reprints. (kt)

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