1989～1998年中国麻风新发患者的畸残状况

目的了解中国近10年来麻风新发患者的畸残状况,为制定预防措施提供科学依据.方法选择1989～1998年全国各县、市的22437例麻风现症病例初诊登记个案资料,由全国性病麻风病控制中心疫情监测系统提供数据.结果1989年全国麻风新发患者的畸残比为46 .49%,到1998年为32.31%;Ⅱ级畸残比由1989年的25.55%,到1998年的20.23%;有18个省(市)畸残比超过40%.畸残者中,Ⅰ、Ⅱ级畸残分别为37.86%和60.64%,另1.5%为仅有脱眉、面瘫、塌鼻等其他畸残,Ⅱ级畸残人数超过50%的有25个省(市).年龄在15岁以下的畸残比为24%,15～65岁者为39.85%,65岁以上者为53.33%.麻风病期在2年以内发生畸残比为29.85%,超过2年和5年者为48.82%和61.17%.有过麻风反应发生畸残比为52.9 %;神经损害3条以上者发生畸残比为46.1%.少菌型患者的Ⅱ级畸残比(28.99%)明显高于多菌型(22.04%).结论中国麻风新发患者的畸残比较高,近10年虽有下降,但其程度无变化.因麻风诊断的延迟、麻风反应及麻风型别的不同,畸残比差异非常明显,与性别、年龄间差异无显著性.早期发现患者,规则进行抗麻风联合化疗,有效处理及控制麻风反应是预防新发患者发生畸残的有效方法.     

住院麻风病人的畸残调查

调查140例,发现有Ⅱ级以上畸残者118例(84.29％)。少菌型畸残率达100％,多菌型81.03％。治愈留院者畸残率93.81％,现症病人62.79％。畸残诱因主要为麻风反应(48.31％)和外伤(16.1％)。畸残多在疗前五年和疗后五年之内发生。畸残以眼部(85.71％)为最多,其次是手部(66.43％)和足部(62.86％)。畸残的表现多为视力减退、足底溃疡、爪形指、骨质吸收和眼睑     

东莞市麻风畸残调查

1990年8月对全市麻风包括治愈者进行了畸残调查。1956～1990年6月,全市累计发现麻风3918人,死亡1361人。失访388人,外迁373人,存活1796人;检查1761人(98.05％),其中治愈者1680人,观症81人;男性1291人,女性470人;少菌型1215人,多菌型546人;住院371人,院外1390人;15岁以下1人,16～60岁1121人,50岁以上639人。查发现残疾738人(41.91％);I级43人(5.83％)Ⅱ级323人(43。77％)Ⅲ级372人(50.4l％);无畸残1023人。多菌型的畸残率为62.09％,少菌型为32.84％(P<0.01);院由与院外的畸残患者,分别占91.11％和28,78％(P相似文献   

2014-2019年贵州省新发麻风患者畸残情况分析

分析2014-2019年贵州省新发麻风患者畸残情况,共分析492例新发麻风患者,结果示492例新发麻风患者2级畸残87例（17.68%）,男性2级畸残率（19.94%）高于女性(12.58%),≥60岁(33.96%)高于15～59岁年龄组(15.69%),病期≥2年(37%)高于病期＜2年组 (9%)。患者以皮肤科门诊发现方式为主（33.13%）,其次是线索发现（30.08%）。症状检测、线索调查、接触者检查能减少畸残的发生。     

5627例麻风手部畸残的分析

目的: 了解麻风受累者手部畸残现状及接受手术矫治的意愿.方法: 对江苏11个市/县麻风院内、外存活的14 137例麻风受累者手部畸残现状、畸残相关因素和对手术矫治的需求进行了调查.结果: 麻风受累者手部畸残5627例(39.8%),单手(28.58%)高于双手(11.22%),现症及复发者(53.9%)高于治愈者(39.23%),多菌(65.02%)高于少菌(35.73%).麻风反应者的畸残手增高(78.25%).畸残手常见爪形指和猿掌. 1951只手有手术适应证,1152例(60%)的患者愿意接受手术矫治.结论: 麻风受累者的手部畸残常见,需要建立相应策略开展手术矫治.     

1998-2018年陕西省麻风流行特征分析

目的：了解1998-2018年陕西省麻风流行趋势和流行特征,为开展麻风防治工作提供理论依据。方法：通过全国麻风防治管理信息系统（LEPMIS）收集陕西省1998-2018年麻风病历资料,对麻风发现率、患病率和病例基本情况进行描述性分析。结果：1998-2018年陕西省新发现麻风病例共计477例,年平均发现率为0.070/10万,年平均患病率为0.305/10万;病例平均发现年龄为46.71岁;男女比为2.46:1;多菌型（MB）399例,占83.6% ;II级畸残共148例,畸残率为31.03%;新发现病例平均延迟期为62.01个月。结论：陕西省新发麻风病例依然存在畸残比高、延迟期长和高龄化等情况,应进一步加强低流行状态下麻风的监测,减少传播和畸残的发生。     

荆州地区的麻风畸残调查

湖北荆州地区于1986年对2263例治愈的和现症的麻风患者做了一次畸残调查,发现有畸残者1304 人(57.62％)。畸残与性别无明显关系,40岁以上者较多(54.8％),多菌型者较多,但在患病的早期以少菌型的畸残较多见。肢体畸残以手部较多(45.7％),足部占33.5％。畸残的表现多为爪形手、猿掌、垂足、溃疡,脱眉和兔眼等。     

云南勐腊县391例麻风新发病人畸残影响因素分析

目的：分析勐腊县近70年麻风新发患者畸残情况及影响因素。方法：收集勐腊县历年麻风患者资料,采用二元logistic回归分析方法分析麻风畸残的影响因素。结果：共分析勐腊县麻风患者391例,麻风新发病例畸残率46.04%（180/391）,其中2 级畸残率44.50%（174/391）。延迟期2～5年、5～10年、≥10年的麻风患者发生畸残风险分别是延迟期＜2年的2.49倍（P=0.018）、4.8倍（P＜0.001）和14.56倍（P＜0.001）;家外传染的麻风畸残风险是家内传染的1.93倍（P=0.030）;有麻风反应的麻风畸残风险是没有反应的2.36倍（P=0.010）;神经损害数2～4条和＞4条的麻风畸残风险分别是神经损害1条的3.37倍（P=0.029）和5.09倍（P=0.009）。结论：勐腊县麻风畸残的危险因素主要有延迟期、家外传染、麻风反应、神经损害数。     

陕西省麻风新发病例基本情况分析

通过全国麻风防治管理信息系统（LEPMIS）收集陕西省2004-2020年麻风病例资料,对新发麻风患者的基本情况进行回顾性分析。研究纳入了305个麻风新发病例,其中男212例,女93例,MB型麻风272例(89.2%),PB型麻风33例(10.82%)。60岁以上患者49例,20～59岁247例,20以下患者9例。100例（32.8%）有家庭内接触史。42例（13.8%）出现麻风反应,247例（81%）出现神经损害,男性神经损伤率高于女性（86.3% vs 68.8%）。218例（71.5%）出现畸残,其中II级畸残122例,I级畸残96例。     

贵州省麻风存活病例畸残现状及相关因素分析

了解贵州省麻风受累者的畸残现状及相关影响因素.采用统一的调查表,对截止2008年底贵州省所有存活的麻风病人及治愈者进行入户调查.共调查麻风病人27 544例,其中10 429例存活麻风病人中,畸残病人5655例,占存活病人54.22%,麻风畸残率随年龄增加而升高;少菌型患者的Ⅱ级畸残比明显高于多菌型患者(P<0.001);不同职业之间畸残有差异(P<0.001),以农民的畸残率最高54.91%;麻风村病人的眼、手、足Ⅱ级畸残率均明显高于家庭治疗病人(P<0.001);麻风Ⅱ级畸残者使劳动及生活自理能力部分丧失或完全丧失.贵州省10 429例麻风受累者中畸残率较高,与年龄、麻风型别、职业等因素有关,提示需加强病例的早期发现,规则进行抗麻风联合化疗,控制麻风反应、神经炎,推广麻风康复技术,仍然是贵州省降低麻风畸残率主要措施.     

广东省韶关市1996～2015年新发麻风病例流行病学分析

目的:了解广东省韶关市1996~2015年麻风病例流行学特征,为低流行状态下麻风防治工作提供依据。方法:收集近20年新发现麻风病例资料,并对其流行病学特征进行分析。结果:20年来麻风病的发现率和患病率呈下降趋势,地区分布不均衡,南雄市新发病例数最多,占总数的64.46%。从发病到确诊的平均延迟期为(58.75±64.31)个月,以多菌型为主,占73.08%,2级畸残比为23.08%,出现2级畸残者的病期显著长于无畸残者(t=2.16,P<0.05)。病例发现以门诊发现等被动发现方式为主,约占67.31%。结论:近20年来韶关市麻风流行状况已经得到有效控制。     

Dynamics of impairment during and after treatment: the AMFES cohort

This study investigates the dynamics of impairment during and after multidrug therapy treatment for the patient cohort of the prospective ALERT MDT Field Evaluation Study (AMFES). The impairment status was compared at intake, at release from treatment (rft), and at the time of the latest survey between 24 and 48 months after release from treatment (follow-up). The eye-hand-foot impairment score (EHF score), which is the sum of the WHO impairment grades of the eyes, hands, and feet, was used as tool for comparison. In all, 433 out of the 592 patients (224 PB and 209 MB) completed treatment in time and were assessed at release from treatment. The risk of getting impaired was 4% for the 113 PB and 21% for the 91 MB patients who were initially free from impairment. Out of the 111 initially impaired PB patients, 41% recovered or improved and 13% worsened in EHF score. For the 118 initially impaired MB patients, these figures were: recovery or improvement 43% and worsening 13%. Three hundred and twenty-three out of the 433 patients (158 PB and 165 MB) had a follow-up examination in between the next 24-48 months after rft. The risks of impairment at follow-up were 6% for the 79 PB and 18% for the 77 MB patients without impairment at rft. Out of the 79 PB patients with impairment at rft, 35% recovered or improved and 28% worsened. For the 88 impaired MB patients, these figures were: recovery or improvement 26% and worsening 27%. Patients showed a tendency to compensate EHF score improvement before rft by worsening after rft and vice versa. The first main conclusion is that the impairment status at intake was by far the most important determinant for future impairment. The second one is that the dynamics of impairment were less favourable after rft than before. Little is known about the long-term fate of leprosy patients with irreversible nerve damage and the associated risk of developing severe secondary impairment. Especially in this era of the leprosy elimination goal, we should give this accumulating patient group due attention in research and health policy agendas.     

2005-2020年贵阳市麻风流行病学特征分析

目的：了解贵阳市2005-2020年麻风的流行病学特征。方法：通过全国麻风防治管理信息系统（LEPMIS）收集整理贵阳市2005-2020年新、复发麻风患者的详细资料,采用SPSS 18.0软件对麻风病例的一般情况和就诊次数、麻风反应、残疾情况、传染源、发现方式和型别等相关因素进行χ2检验和非条件logistic多因素分析。结果：贵阳市2005-2020年共发现新、复发麻风169例,年均发现率0.260/105,总体呈下降趋势,复发病例7例,其中3例是联合化疗后复发（42.86%）,4例为DDS单疗后复发（57.14%）。169例患者平均年龄(41.88±16.75)岁,儿童病例（14岁及以下）6例,占新发病例的3.55%,MB∶PB=2.13∶1,平均2级残疾比为32.54%,发现方式以皮肤科就诊为主,占31.36%。影响畸残的主要因素为麻风患者的文化程度高低、不同传染源、不同的发现方式和麻风型别。结论：贵阳市麻风流行状态总体呈下降趋势,但2级残疾发病率高并且还有儿童病例（14岁及以下）出现,麻风疫情依然严峻。     

贵州省新发麻风病患者特征分析

目的了解贵州省低流行状态下新发麻风患者特征,为今后发现更多早期麻风患者,有效降低2级残疾比提供科学的依据。方法采用统一问卷进行现场一对一的调查,并将患者调查问卷和病案信息录入EXCEL表格建立数据库,用SPSS18.0软件进行分析。结果贵州省2012-2018新发的387例麻风患者中,男281例,女106例,男∶女=2.65∶1,14岁及以下患者占4.13%,平均延迟期为43.80个月。周围神经受损主要有尺神经311例(80.36%)、腓总神经176例(45.48%)、耳大神经125例(32.30%),皮损主要有麻木98例(25.32%)、红斑95例(24.55%)、脱眉85例(21.96%)。MB型占75.50%,MB∶PB=3.07∶1,通过比较,麻风的不同型别在性别、年龄和延迟期之间无差异,但少数民族患者的MB型显著性高于汉族(P<0.05),有明确传染源的MB型患者高于不明传染源的(P<0.05),差异均有统计学意义。病期在2年内且无疾残的早期患者为220例(56.85%),以文化程度较高(初中以上)的早期患者为主(70.59%)。不明传染源的患者2级残疾比明显高于有明确传染源的患者,差异有统计学意义(P<0.001),延迟期越长,残疾情况越严重。94.44%的14岁及以下患者均有明确的传染源接触史。结论近年来贵州省新发麻风以多菌型为主,且每年都有儿童患者被发现,仍有局部流行风险,患者延迟诊断情况较严重,急待提升医务人员识别早期麻风能力和患者接触检查质量,实现麻风患者的早期发现。     

重复开展消除麻风运动对当地新发现病人情况的影响

目的:观察贵州省兴义市重复开展消除麻风运动对当地新发现麻风病人的影响.方法:收集1996～2004年新发现麻风病人的有关资料进行比较分析.结果:9年共发现麻风病人166例,平均每年发现18.4例,年均发现率为2.65/10万.1999年首次开展消除麻风运动后3年,新病人中的2级畸残率和延迟期呈明显下降趋势,低于开展前3年的水平.两次开展消除麻风运动时的畸残率和平均延迟期均达较高水平,提示该地区虽两次开展消除麻风运动但麻风流行程度仍处于较高水平.结论:重复实施消除麻风运动可促进某些流行病学指标的好转,应反复多次开展.     

Nerve function impairment in leprosy: design, methodology, and intake status of a prospective cohort study of 2664 new leprosy cases in Bangladesh (The Bangladesh Acute Nerve Damage Study).

The Bangladesh Acute Nerve Damage Study (BANDS) is a prospective cohort study designed to investigate epidemiological, diagnostic, therapeutic and operational aspects of acute nerve function impairment in leprosy. The study is based at a single centre in Bangladesh, in an area with a high prevalence of leprosy. The centre, Danish Bangladesh Leprosy Mission, has a well-established vertical leprosy control programme. In this paper, the study design and methodology are described, together with definitions of nerve function impairment (NFI) used in this and subsequent papers. The study recruited 2664 new leprosy cases in a 12-month period. The male:female ratio is 1.25:1, and 17.61% of the cohort are under 15 years of age. In all, 83.33% of the cohort are paucibacillary (PB), and 16.67% multibacillary (MB). However, the MB rate amongst males is 19.72%, and amongst females is 12.85%, despite an equal period of delay to diagnosis. 55% of patients presented for treatment within 12 months of developing symptoms 6.12% of the total number of cases were smear positive, and 36.71% of the MB cases were smear positive. 9.61% of the total number of cases were graded as having World Health Organisation (WHO) disability grade 1, and 5.97% had grade 2. Amongst MB cases, 27.48% had WHO grade 1 disability present, and 18.24% had grade 2 present, compared with 6.04% and 3.51%, respectively, amongst PB cases. A total of 11.90% of the cohort had sensory NFI of any kind, and 7.39% had motor NFI. Ninety patients presented with NFI needing treatment (3.38%), and of these, 61 (67.78%) had silent NFI. MB patients had a prevalence of reaction/NFI needing treatment nearly 7 times higher than PB cases (15.32% amongst MB; 2.30% amongst PB), and males nearly double that of females (5.67% amongst males, 2.96% amongst females). The most commonly affected nerve by function impairment was the posterior tibial (sensory) with 6.46% of nerves affected (9.38% of patients), followed by the ulnar nerve with 3.23% of nerves impaired (5.56% of patients). Future research and publications, building on this foundation, will focus on the following areas: the incidence of NFI and reactive events, the risk factors for developing NFI, and the response to treatment of patients developing acute NFI.     

A study on the impact of FD-MDT on 200 leprosy patients

A study was carried out from June 1999 to June 2001 to assess the impact of fixed duration multidrug therapy (FD-MDT) in newly detected cases of leprosy in terms of clinical and neurological improvement and changes in the bacillary index of skin smear for AFB. 200 new leprosy cases (both PB & MB) were started on FD-MDT. Of these 200 cases, 16 were of pure neuritic leprosy. After treatment, out of 184 cases with typical skin lesions of leprosy, all 26 PB cases showed inactivity of skin lesions, and, of the remaining 158 MB cases, 40.5% showed inactivity and 59.5% showed complete resolution of skin lesions. Out of 68 skin smear-positive cases, 42 cases with a BI of < or = 3 became smear-negative, while others showed gradual fall in the BI. Such heavily bacilliferous cases were continued with treatment for 1 more year to prevent relapse. As FD-MDT alone does not cure established sensory and motor impairment, it did not show any change in 19% of the patients presented with permanent sensory motor disturbance. FD-MDT prevents progression of sensory/motor disturbance.     

2235例麻风垂足的分析

目的：了解麻风垂足的患病情况，为制定预防措施提供科学依据。方法：选择江苏11个县市存活的麻风治愈者及现症患者为调查对象，资料输入计算机统计分析。结果：麻风垂足的患病率为15．7％，单足（13．62％）高于双足（2．07％），男性（16．36％）高于女性（13．84％）,现症及复发病人（31．28％）高于治愈者（15．07％），BT、BB型麻风占23．56％及20．96％。麻风病期在5年以内发生垂足的少菌型麻风（72．41％）高于多菌型（50．47％）；发生过麻风反应的患者垂足占33．75％。垂足有足底溃疡（21．21％）、足骨破坏（19．17％）及足畸形（27．43％）多于无垂足的溃疡（15％）、骨破坏（15．09％）及足畸形（20．19％）。989只垂足可通过手术矫治，要求治疗者只占30％。结论：麻风垂足以男性、现症及复发病人多见且以单足为主，垂足发生的足底溃疡及足畸形明显增多，三分之二的垂足失去了手术矫治的机会，70％的患者对垂足的治疗没有信心。麻风垂足的发生与麻风诊断和治疗的延迟、麻风反应及麻风型别的不同有明显的关系。