MB病人用WHO MDT后的复发

1984～86年间作者以WHO的MDT方案治疗多菌型麻风44人;完成疗程后9人失访,随访的35人中LL6人,BL 29人,疗前皆有活动性皮损,麻风菌素反应(一),BI 1.0～5.2,其中18例≥4.0,28例≥5.0。完成MDT后所有患者的活动性皮损均消退,但31例涂片仍阳性。复发     

PB型麻风复发转型2例

米易县麻风防治工作始于1959年,截至2006年共发现病人609例,1986年前主要采用氨苯砜(DDS)单疗为主,1986年7月开始实施WHO的MDT方案治疗麻风,现将1例DDS单疗治愈、1例MDT治愈后复发,发生病型转型报告如下。1临床资料例1男,52岁,汉族,农民。1967年诊断为TT型麻风,采用DDS治疗,于1976年12月判愈出院,1997年复查时发现患者面部、胸部浸润大小不等、边界不清的淡红斑,双足干燥,皮肤涂片查菌BI2 ,病理查菌阳性(3 )~(4 ),病理诊断BL型麻风。例2男,53岁,汉族,农民。1986年发现左侧腰部一块4cm×4cm大小红斑,皮肤涂片查菌阴性,病理查菌阳性…     

多菌型麻风固定疗期联合化疗的疗效和并发症

作者报告多菌型麻风(MB)经2年固定疗期联合化疗(MDT)治疗的疗效和并发症。MB病例条件为:①皮肤查菌阳性的瘤型(LL)和界线类偏瘤型(BI)病例;②未经治疗过者;③曾用DDS单疗不足24周者;④对所用抗麻风药物无禁忌证者。疗期为WHO推荐的MB麻风MDT方案治疗2年。复发标准为细菌指数比以前增加1+以上,伴或不伴有临床体征。在监     

少菌型麻风固定疗期的联合化疗

对WHO推荐的少菌型麻风联合化疗(MDT)方案的疗效进行了研究,并与常规DDS单疗的疗效进行了比较。研究对象为54例具单个皮损的新发少菌型病人。初诊时进行临床分类、皮肤涂片查菌、病理检查和麻风菌素试验,然后随机分为两组。MDT组为28例患者(TT21例,BT 7例),给予WHO推荐的少菌型MDT方案,疗期6个月。在治疗期间每月随访一次,治疗结束后每隔半     

西昌市多菌型麻风联合化疗后二年的观察

西昌市70例多菌型麻风用WHO的MDT方案已完成治疗并监测二年。13例新病人疗后一年皮损均消退,监测二年时12例细菌阴转(92.3％);疗后出现ENL1例,Ⅰ型反应5例(38.46％)。曾治疗过的57例用MDT前大部分皮损消退,BI偏低,监测二年时细菌阴转56例(98.24％);疗前ENL13例,神经痛2例,MDT后症状逐渐减轻,21个月时发生Ⅰ型反应1例(1.75％)。两组监测二年均未发现复发,还在继续观察。     

麻风病

962444 667例多菌型麻风MDT后监测5年/赖祖杰…//中国麻风杂志。-1996,12(2).-104～105 用WHO MDT MB方案治疗的667例多菌型麻风中(经治组608例,未治组59例)治疗24个月停药时两组临床活动性皮损大部分消退,平均BI分别下降0.6和0.84,监测期间BI逐次下降。监测5年时分别有603例和58例细菌阴转,阴转率分别是99.17％和     

157例 MB 麻风 MDT 后的细菌变化及复发

为评价用 MDT 后 MB 麻风的远期复发率,对江苏扬州地区和东台市1983～1993年登记的711例 MB 麻风连续用 MDT 至皮肤查菌阴性,从中选择疗前 BI≥2.6和1990年12月以前停药者进行随访,共157例,其中65例(41.40%)已停药随访7年以上;达到皮肤查菌阴性者,用 MDT 时间最短者为2年,最长者为6年(平均为47.7月);治疗4年时的阴转率为75.16%,5年为97.45%,5年内 BI 年均下降0.69;共随访946人年,平均每例随访6.02年,有2例分别在停药3年和4.5年时复发(1.3%或2.1/1000人年)。本组资料表明,高菌量的 MB,用 MDT 后的复发率并不更高。应该加强监测,进一步积累复发资料来评价 MDT 的远期疗效。     

替代方案治疗HLA-B*13:01阳性的多菌型麻风患者对细菌指数的影响

目的：比较HLA-B^*13:01基因检测阴性和阳性的新发多菌型麻风患者接受含或不含氨苯砜的治疗方案对细菌指数的影响。方法：HLA-B*13:01基因检测阳性者接受替代方案治疗(不含氨苯砜),阴性者服用世界卫生组织的联合化疗方案（WHO-MDT），比较两组患者在治疗前后细菌指数（BI）的变化。结果：替代方案组随访1年、2年和3年病例数分别为19例、14例和13例，疗前平均BI分别为3.31、3.29和3.54，末次检查平均BI分别为2.63、1.80和1.45；WHO-MDT组病例数分别为35例、33例和24例，治疗前平均BI分别为3.31、3.19和3.30，末次检查平均BI分别为2.22、1.68和0.81。替代方案组和MDT组中随访1年、2年、3年患者的BI变化值分别比较，差异均无统计学意义，（均P＞0.05）。结论：从BI变化看，替代方案和WHO-MDT对多菌性麻风的治疗同样有效。     

MDT与MB病人的细菌阴转

有人认为MDT并不加速细菌的清除,故不少病人治疗2年后BI仍阳性,和DDS单疗相似,因此作者认为对MB病人疗程要延长到3年。选60例经MDT后细菌阴性的病人(LL 25、BL 33、BB 2),平均38岁。仅13例(21.7％)治疗2年后BI阴性,5例(8.3％)6年多变阴性,     

44例麻风MDT后复发报告

目的探讨(2010~2017)年云南省麻风MDT治疗后复发病例的特点。方法通过"全国麻风疫情管理信息系统"(LEPMIS)对云南省(2010~2017)年麻风联合化疗治疗后复发者个案资料进行分析。结果 8年中MDT疗后复发44例,同期单一DDS复发34例,平均间隔期389.4个月。MDT复发者以多菌型为主,平均复发间隔17.3个月。结论麻风MDT疗后复发具有长期危险性,并且复发与患者的含菌量有关。     

环戊利福霉素对麻风菌感染的实验治疗效果

本文报告以小鼠足垫模型比较RMP和R-77-3抗麻风菌感染的效果.每4周给药一次,R-77-3的ED5.剂量远低于RMP,用比例杀菌试验发现R-77-3对麻风菌的杀菌作用明显强于RMp.上述体内杭菌作用的显著差别主要由于R-77-3具有优异的药物动力学特性,T1/2比RMP长得多.提示R-77-3有可能比RMP更适合于麻风的间歇治疗.     

M. leprae recombinant antigens important for T-cell reactivity.

Identification of M. leprae antigens recognized by T-cell is important for specific diagnosis, vaccine development and understanding the basic mechanisms involved in protection against and pathogenesis of leprosy. Screening of an M. leprae recombinant DNA library with antibody probes led to the identification of half a dozen M. leprae antigens recognized by B-cells. When tested for T-cell reactivity, all the antigens recognized by antibodies were shown to have T-cell reactivity. However, among these antigens 18 kDa, 65 kDa and 70 kDa heat shock proteins (hsps) were most frequently recognized by T-cell lines and clones established from healthy donors vaccinated with killed M. leprae. A 24 kDa secreted antigen of M. leprae with T-cell epitope specific for M. leprae and M. tuberculosis complex was identified by direct screening of the recombinant DNA library with T-cell clones. The recombinant T-cell antigens of M. leprae were recognized by memory T-cells of Th1 type in association with multiple HLA-DR molecules. Epitope mapping with synthetic peptides identified M. leprae-specific as well as cross-reactive T-cell epitopes on the 18 kDa, 65 kDa and 70 kDa hsp antigens. In conclusion, our studies suggest that the recombinant antigens of M. leprae could be useful as reagents for specific diagnosis as well as in subunit and recombinant vaccine design against leprosy.     

Observations on nerve tissue infected with M. leprae

Nerve tissue from leprosy patients showed (i) small linear pinkish translucent crystalloid bodies, (ii) small round structures in relation to filamentous strands, (iii) short pieces of filaments with round spaces within them and (iv) miscellaneous structures like pink granules, brown bodies and dark masses. These structures are being studied for their relationship to leprosy.     

Influence of levamisole on lymphocytes and M. leprae in mice

Normal uninfected (N) and M. leprae infected mice (NI) were given levamisole in the dose of 2.5 mg/kg body weight. The animals were observed over a period of nine months for bacillary load, T and B cell counts and blast transformation with PHA. Significant increase in B cell counts was observed in the levamisole treated normal (NL) compared to normal control (N) group. T cell counts and blast transformation, however, remained unaffected. However, T-cell counts and blast transformation improved significantly in the infected and levamisole treated (NIL) as compared to the infected group (NI) not given levamisole. Bacillary loads remained unaltered in both, the infected (NI) and levamisole treated (NIL) group.     

Effect of diet on growth of M. leprae in mouse footpads

Semipurified diets, with equal amounts of vitamins, minerals and fibre, but varied in protein and fat content from pork, barbel fish or soya beans were tested for their possible effect on the growth of M. leprae in mouse footpads. 105 BALB/c male weanling mice were randomly divided into five diet groups of 21 mice each and fed for six months. Differences between bacterial counts of diet groups were found. The mouse foot pad model is suitable for dietary study in leprosy.     

Postgenomic Mycobacterium leprae antigens for cellular and serological diagnosis of M. leprae exposure, infection and leprosy disease

Due to changes in leprosy control programs and the special expertise required for diagnosis, the need for simple rapid diagnostic tests that could be applied in non-expert settings may now be greater than ever before. Since the sequencing of the M. leprae genome, many research groups have investigated the potential of M. leprae antigens in either serologic or cell mediated assays. Here we provide an overview of the nearly 200 recombinant single proteins that were investigated during the last decade for their potential to be applied in field-friendly tests for the early diagnosis of leprosy.