156例麻风患者治疗转归回顾性分析

目的了解麻风的治疗方法,为今后规范治疗麻风患者提供参考。方法对腾冲市156例麻风患者治疗情况进行统计分析。结果腾冲市(1953～2018)年共治疗麻风患者156例(未完成疗程死亡21例),完成疗程134例,治愈130例,治愈率达97.0%。结论麻风患者的早期发现、早诊断、早期、及时、足量、足程、规则联合化疗(MDT)可治愈麻风。     

649例麻风病联合化疗效果分析

甘肃省全面实施WHO推荐的麻风病联合化疗(MDT),截止2009年底已累计治愈649例.现将疗效监测结果总结分析如下. 1 资料和方法 1.1 一般资料 截止2009年底,全省累计发现麻风患者4864例,其中多菌型3792例,少菌型1072例,累计治愈3603例;累计复发320例次,累计接受MDT治疗720例,其中,治疗期间死亡35例,年底尚在接受治疗25例,完成MDT治疗660例.     

联合化疗中麻风反应的临床特征及糖皮质激素治疗的效果分析

目的了解麻风联合化疗时麻风反应的发生情况,评价糖皮质激素对麻风反应的治疗效果。方法对本市1986-2005年采用联合化疗方案治疗后达到临床治愈的新发及复发麻风病人的临床资料进行回顾性分析。结果 63例进行联合化疗的麻风患者,有37例曾经发生72例次麻风反应,23例发生Ⅰ型麻风反应34例次,15例发生Ⅱ型麻风反应31例次,7例发生混合型麻风反应7例次;且73.53%麻风反应发生在联合化疗1年内,Ⅱ型麻风反应均出现在联合化疗1年后,但是混合型麻风反应出现时间不一。麻风反应以皮肤和周围神经症状为主要表现,其中Ⅰ型、Ⅱ型和混合型麻风反应发生时有皮肤症状者分别占64.71%,100%和100%,有神经受累者分别占100%,61.29%和42.86%。治愈24例次,显效19例次,好转21例次,无效0例次,恶化8例次,有效率为59.72%。糖皮质激素治疗后25例次(34.72%)出现胃部不适,16例次出现满月脸多血质,7例次出现骨质疏松症样疼痛,但是均未影响治疗。结论麻风联合化疗患者麻风反应高发,神经受累相对较多,激素治疗麻风反应有一定的效果,但治疗方案仍有改进的空间。     

中国12403例麻风复发病例分析

目的研究1949～1998年用氨苯砜单疗或联合化疗后麻风患者的复发趋势和特点 .方法应用电脑对收集自中国1949～1998年的麻风复发个案资料进行分析.结果1949～1998 年间累计复发患者12403例,累计复发率为3.28%.其中氨苯砜单疗复发11803例,复发率为 3.83%.联合化疗复发236例,复发率为0.57%.经治少菌型麻风联合化疗半年的复发率(0 .84%)显著高于初治少菌型麻风联合化疗半年的复发率(0.36%).经治多菌型麻风联合化疗2年的复发率(0.37%)也显著高于初治多菌型麻风联合化疗2年的复发率(0.23%). 复发患者Ⅱ级畸残率及细菌的阳性率分别为49.9%和69.3%.结论氨苯砜单疗复发高峰出现于1959～1988年间,联合化疗复发出现于80年代末,并在未来的10～20年可能达高峰.     

云南省2004年麻风疫情分析

由于地理及经济条件的制约,我省麻风流行范围遍及129个县(市),经过50多年的积极防治,目前流行范围、流行强度明显缩小和减弱。截止2004年底,全省累计发现麻风病人53 291例(其中含复发1 042例),累计治愈40 065例,死亡、外迁及其它减少11 780例,尚有现症病人1 440例,患病率为0.33/万,见表1。本年度发现新病人数392例(MB 264例、PB 128例),发现率0.89/10万;查菌阳性数占新发现病人总数的70.15%(275/392);其中复发病人36例(MB 35例、PB 1例),7例为联合化疗复发,29例为单疗复发;型比为67.35%(264/392);2级畸残率25.77%(108/392);≤14岁儿童比…     

麻风患者完成联合化疗后的临床与病理改变

目的 观察完成治疗后的麻风患者临床与组织病理变化，评估治愈标准，提高皮肤科医生长期随访意识。方法 收集在麻风防治专业机构接受联合化疗(MDT)方案规则服药结束至本科复查的麻风患者临床资料，对其组织蜡块切片后做HE染色和抗酸染色，观察病理特点；根据收集的临床及病理资料进行回顾性分析。结果 收集到19例治疗后具有完整资料的麻风患者，11例(57.89%)达到临床治愈标准，临床上均无活动性麻风皮损，部分留有色沉、色减或鱼鳞病样改变。11例治愈者中，5例(45.45%)组织病理呈非特异性炎症改变，6例(54.55%)呈麻风消退后期改变，肉芽肿较小，泡沫细胞处于退行期；2例(18.18%)组织抗酸染色见碎裂状、颗粒状麻风杆菌。8例患者(42.11%,8/19)未达临床治愈标准，皮损部分未消退，以色减斑、色沉斑、暗红斑为主，4例(50.00%,4/8)存在Ⅱ型麻风反应，伴红斑、结节、脓疱；病理上均有肉芽肿形成，但肉芽肿较小，肉芽肿中的泡沫细胞处于退行期；组织抗酸染色见完整麻风杆菌，均为多菌型。结论 麻风患者通过MDT治疗方案服药结束后，仍需复查组织病理及抗酸染色评估是否达到治愈。部分多菌型麻风患者...     

泰州市居家麻风治愈存活者生存现状调查与分析

目的：了解江苏省泰州市居家麻风治愈者生存现状。方法：采用统一调查表，对泰州市存活麻风患者进行调查，资料进行Epidata录入和分析。结果：调查居家麻风治愈者2428例，男1722例，女706例，男女性别比2.44∶1，平均年龄73.13岁。被调查者中有50.66%有不同程度畸残，有20%享受到低保或农村五保福利，独居的占22.41%，生活不能自理的占6.38%。结论：泰州市的居家麻风治愈者年龄结构老龄化，生活困难，需进一步加强社会保障。     

37例复发麻风的分析

我院1955建院,至1990年累计收治1195例麻风患者,其中男956例,女239例;MB 889例,PB 306例;病期4个月～13年;治愈874例,死亡155例,外出128例;复发37例,占住院总人数的3.09％,占治愈人数的4.23%。复发的TT型和LL型麻风,复发年龄19～78岁;男性34例,女性3例;复发时间1个月～10年;与传染源没有差异,复发者都是用DDS单疗,联合化疗无一例复发。     

贵州省81例麻风不良反应特征及相关因素分析

目的了解麻风不良反应的发生特征及相关因素。方法对贵州省81例登记麻风不良反应的麻风患者病历资料进行回顾性分析。结果 81例不良反应麻风患者中,Ⅰ型麻风反应12例(14.81%),Ⅱ型麻风反应41例(50.62%),混合型麻风反应9例(11.11%),单纯神经炎19例(23.46%)。40例(49.38%)麻风反应发生在联合化疗治疗前,26例(32.10%)发生在联合化疗中,15例(18.52%)发生在完成联合化疗后;Ⅰ型麻风反应、单纯神经炎发生多在开始MDT治疗1年内,Ⅱ型麻风反应多发生在MDT治疗结束后。神经损害均以双侧为主,尺神经炎发生率最高,为53.85%,麻风不良反应的发生与细菌指数有关(P0.05)。结论需进一步提高麻风不良反应的早期诊断水平,BI≥2.0的麻风患者、MDT治疗期间及治完后都要密切监测麻风不良反应的发生以减少麻风残疾的发生。     

大理州联合化疗8年的效果

大理州是麻风流行区,自1988年3月普遍用联合化疗以来,累计治疗1068例,覆盖率为100％,治愈952人(89.14％);规则治疗率100％;1987年有现症病人769例,1995年还有116例,减少了84.92％;1987年患病率为     

卡介苗(BCG)多克隆抗体的免疫组化染色技术在麻风菌检测中的应用(附120例麻风病检测报告)

目的：讨论卡介苗(BCG)多克隆抗体对麻风病的早期诊断，治疗效果评估和复发病人发现的作用。方法：收集120例完成MDT、复发、少菌麻风病例。采用免疫组化技术BCG多克隆抗体检测标本组织中麻风杆菌抗原并与10％高碘酸氧化后做抗酸染色和一般抗酸染色做对比。结果：BCG组阳性率比10％高碘酸氧化后抗酸染色和一般抗酸染色高。结论：BCG多克隆抗体免疫组化染色对麻风病的早期诊断、治疗效果评估、复发的及时发现是一项操作简单而且敏感性高，是较有价值的检测项目。     

Comparative leprosy vaccine trial in south India

This report provides results from a controlled, double blind, randomized, prophylactic leprosy vaccine trial conducted in South India. Four vaccines, viz BCG, BCG+ killed M. leprae, M.w and ICRC were studied in this trial in comparison with normal saline placebo. From about 3,00,000 people, 2,16,000 were found eligible for vaccination and among them, 1,71,400 volunteered to participate in the study. Intake for the study was completed in two and a half years from January 1991. There was no instance of serious toxicity or side effects subsequent to vaccination for which premature decoding was required. All the vaccine candidates were safe for human use. Decoding was done after the completion of the second resurvey in December 1998. Results for vaccine efficacy are based on examination of more than 70% of the original "vaccinated" cohort population, in both the first and the second resurveys. It was possible to assess the overall protective efficacy of the candidate vaccines against leprosy as such. Observed incidence rates were not sufficiently high to ascertain the protective efficacy of the candidate vaccines against progressive and serious forms of leprosy. BCG+ killed M. leprae provided 64% protection (CI 50.4-73.9), ICRC provided 65.5% protection (CI 48.0-77.0), M.w gave 25.7% protection (CI 1.9-43.8) and BCG gave 34.1% protection (CI 13.5-49.8). Protection observed with the ICRC vaccine and the combination vaccine (BCG+ killed M. leprae) meets the requirement of public health utility and these vaccines deserve further consideration for their ultimate applicability in leprosy prevention.     

A study of ocular complications in leprosy

A total of 380 leprosy patients were studied in four different leprosy hospitals. The involvement of eye was found in 18.95% of cases in which 10.97% in lepromatous leprosy and 8.16% in non-lepromatous leprosy cases. In total cases studied 52.63% were of lepromatous leprosy and 47.37% of non lepromatous leprosy cases. Among them 11.05% were males and 18.95% were females. In 72 cases of ocular involvement, males constituted 80.56% and females 19.44% of cases. Maximum cases (52.78%) of ocular involvement were in leprosy patient with 5 to 10 years of duration. Blindness among the total leprosy patients studied was 1.84% which was mainly due to corneal opacity following exposure keratitis and ulceration, iridocyclitis and its complications.     

A Rapid Method for the Cytodiagnosis of Multibacillary Leprosy

The diagnosis of leprosy is made clinically with histologic and cytologic confirmation. The traditional methods for making the cytologic diagnosis of leprosy take time and training, making them unsuitable for rapid office use. We describe a simple, rapid method for cytologic confirmation of the diagnosis of multibacillary leprosy using slit skin scrapings.     

深圳市基层医务人员和居民麻风病知识调查

目的　了解低流行状态下深圳市基层医务人员和居民麻风病知识水平。方法　采用自行设计的麻风病知识调查问卷进行调查。结果　 76.3 4%的基层医务人员不知道如何治疗麻风病人 ;68.75 %的居民认为麻风病传染性极大 ,5 6.2 5 %的居民认为与麻风病人一起工作学习十分可怕。结论　基层医务人员对于麻风病知识的掌握并不全面 ,在居民中还存在对麻风病人的严重歧视现象 ;需要进一步对基层医务人员和居民进行麻风病专业知识培训及广泛的宣传教育。     

泼尼松治疗麻风神经炎疗效评价

目的：评价泼尼松治疗麻风神经炎的疗效.方法：对麻风急性神经炎32例和无痛性神经炎28例,共60例患者给予泼尼松顿服治疗6个月,定期评价神经功能变化.结果：急性神经炎患者痊愈率65.3%,总有效率为95.7%;无痛性神经炎患者痊愈率35.1%,总有效率为78.4%.结论：泼尼松治疗对急性神经炎患者疗效显著,6个月内的无痛性神经炎患者也有较好的疗效,可作为治疗麻风神经炎首选药物.     

上转换发光技术侧流免疫夹心法检测59例麻风患者和87例家庭接触者PGL-I抗体结果分析

目的：评估上转换发光技术侧流免疫夹心法（UCP-LFA）检测PGL-I抗体对麻风接触者发病风险预测的价值。方法：采用UCP-LFA 方法检测贵州59例麻风患者、87例家庭接触者和55例健康对照进行PGL-I抗体水平。数据统计采用SPSS 20.0进行卡方分析。根据ROC曲线确定临界值。结果：麻风患者中PGL-I抗体阳性率为81.4%、麻风接触者为5.7%、健康对照人群为1.8%,三组人群PGL-I抗体阳性率差异有统计学意义（χ2 =126.47,P<0.005）。少菌型和多菌型PGL-I抗体阳性率分别为40% 和89%,差异有统计学意义（χ2=13.386,P<0.005）。BI+、BI-患者PGL-I抗体阳性率分别为83%和0%,差异有统计学意义（χ2 =17.560,P<0.005）。结论：麻风患者PGL-1抗体阳性率>麻风病接触者>正常对照,多菌型PGL-1抗体阳性率高于少菌型,提示PGL-I IgM抗体水平对麻风发病有一定的预测作用。     

Current situation of leprosy colonies/leprosaria and their future in P.R. China

OBJECTIVE: To identify the current situation of leprosy colonies/leprosaria and make some recommendations for improving the quality of life of people affected by leprosy in China. METHODS: A national survey using designed forms was carried out in 2004. The forms were filled in by local heads responsible for the management of leprosy colonies/leprosaria and sent to Provincial and National Centres for analysis. RESULTS: China had 605 leprosy colonies/leprosaria with 555 active leprosy patients (on treatment) and 18,175 ex-patients (people affected by leprosy) living in them at the end of 2004. Among 18,730 patients and people affected by leprosy, 13,430 (71.7%) had grade 2 disabilities. Among those with visible disability, 6392 (47.6%) lost the ability to take care of themselves due to serious deformity. Because of a decrease in health workers working at leprosy colonies and a shortage of medical materials, the health care quality of these people was neglected. Most colonies/leprosaria were located at remote and isolateS places with difficult transportation, and most buildings/houses were in danger of collapse because the colonies/leprosaria were built in the 1950's. Those affected by leprosy were in great need of help. CONCLUSION: The authors recommend that small, remote and isolated leprosy colonies should be closed. New leprosaria at District, Provincial or National levels should be established or some old leprosaria with good transportation should be reconstructed to house those affected by leprosy from closed leprosy colonies/leprosaria. The newly established or reconstructed leprosaria could act as centres for reference, training, rehabilitation and research on leprosy.     

Leprosy case detection using schoolchildren

An innovative method that combined awareness creation with screening of high school students by their peers was undertaken in 26 randomly selected schools in the project area of the Schieffelin Leprosy Research and Training Center, Karigiri, Vellore, India. This method entailed educating teachers and student leaders in grades 8-12 about leprosy and how to suspect leprosy among their peers. The student leaders in turn conducted a similar awareness programme for their peers and encouraged them to report if they suffered from any skin problem or skin lesion. Based on the reporting by their peers, the class leaders prepared a 'suspect list'. Within a fortnight of the awareness program, a trained leprosy worker visited the school and examined all the students on the 'suspect list'. Those diagnosed to have leprosy were referred to a medical officer, who then confirmed the diagnosis and initiated treatment. Among the 23,125 students enrolled in the 26 randomly selected schools, 234 student leaders were educated about leprosy and trained to detect suspect lesions among their peers. A total of 2200 (9.5%) children reported with skin lesions to their leaders and after screening by a leprosy supervisor and confirmation by a medical officer, 14 new cases (NCDR 6.05/10,000) were detected. This rate was found to be comparable with case detection rates of annual school surveys done during the National Leprosy Eradication Programme (NLEP), when all schoolchildren were examined. The paper suggests that schoolchildren can be used effectively in leprosy case detection and this method has the additional advantage of creating awareness among them, their teachers and communities.     

Community leaders involvement in leprosy health education

As an alternative approach, 310 community leaders consisting of village political leaders, school teachers, Govt. staff, members of socio-welfare and religious agencies, graduate students and traders from 21 villages of Chingleput district of Tamilnadu (India) were interviewed to explore the possibilities of their involvement in leprosy health education community. Though majority (76%) of respondents were not fully aware about various aspects of leprosy and showed negative reactions (51%) towards leprosy patients; almost all realised the importance of educating community about leprosy for its early control, for which a large majority (88%) of them had expressed their willingness to participate in leprosy health education and control programme by devoting an average of 4.4 +/- 5.4 hours per week. A good number (54%) of them had also been educating people about leprosy in one or the other way. The leaders who had been exposed to leprosy health education especially in recent past, were significantly better equipped with knowledge about leprosy and its control and were much more willing to participate in NLCP, than others. Study concluded that if the community leaders are approached, educate and motivated properly, they would certainly involve themselves to provide a valuable strength to our leprosy health education and control programme.