657例多菌型麻风改良MDT复治后17年监测

目的 :　探讨MDT复治对降低DDS单疗已愈MB病人复发的作用。方法 :　运用改良的MDT对DDS单疗治愈的 6 5 7例MB病人复治 1年 ,并进行临床和细菌学监测 17年 ,进行统计学比较分析。结果 :94 .74 %的病人完成治疗 ,毒副反应少。 1例在随访 14年复发 ,复发率 0 .12 % ,或者 0 .15 10 0 0人年。复治过的病人较未复治者复发率明显下降 (P <0 .0 0 1)。结论 :　复治效果明显 ,但考虑到复治的费用 ,在复发率高、有条件的地区可实施。持久菌引起的麻风晚期复发不可忽视

Monitoring of relapses for 657 MB cured leprosy cases retreated with modified MDT for 17 years

Objective:To investigate the role of MDT re-treatment in decreasing relapse rate for cured cases with DDS monotherapy.Methods: Six hundred and fifty-seven cured cases with DDS monotherapy were retreated with modified MDT for one year and were monitored for 17 years clinically and bacteriologically.Results: Six hundred and twenty (94.74%) of them completed the course. The toxicity and side effects were slight. There was one relapsed after 14 year follow up, with a relapse rate of 0.21% or 0.15/1000 person-years. The relapse rate of the cases retreated was lower, compared with non-retreated cases (P<0.001). Conclusions :The re-treatment was effective in reducing relapse of the patients cured with DDS monotherapy. However, we recommend the MDT re-treatment would be only used in areas with higher relapse rate and good economic condition due to the cost of drugs. Moreover we should not ignore the late relapse caused by persistent bacteria.