中华皮肤科杂志 ›› 2026, Vol. 59 ›› Issue (3): 237-243.doi: 10.35541/cjd.20250302

• 论著 • 上一篇    下一篇

2007—2020年重庆市麻风患者2年期与1年期联合化疗防治效果评估

罗飞1    石粤渝1    肖鹏1    狄林锦2    罗升群3    张信江4    刘智勇5    周爽1   

  1. 1重庆市疾病预防控制中心地方病与寄生虫病预防控制所，重庆  400707；2昆山杜克大学，昆山  215316；3重庆市巴南区皮肤病防治院麻风病防治科，重庆  401320；4重庆市南川区皮肤病防治院麻风病防治科，重庆  408499；5重庆市万州区疾病预防控制中心地方病与寄生虫病预防控制科，重庆  404199
  • 收稿日期:2025-05-26 修回日期:2025-12-04 发布日期:2026-03-03
  • 通讯作者: 周爽 E-mail:15264835@qq.com

Comparison of efficacy of 2-year versus 1-year multidrug therapy for leprosy patients in Chongqing, 2007-2020

Luo Fei1, Shi Yueyu1, Xiao Peng1, Di Linjin2, Luo Shengqun3, Zhang Xinjiang4, Liu Zhiyong5, Zhou Shuang1   

  1. 1Institute of Endemic and Parasitic Diseases Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing 400707, China; 2Duke Kunshan University, Kunshan 215316, China; 3Department of Leprosy Prevention and Treatment, Hospital of Dermatology Prevention and Treatment in Banan District, Chongqing 401320, China; 4Department of Leprosy Prevention and Treatment, Hospital of Dermatology Prevention and Treatment in Nanchuan District, Chongqing 408499, China; 5Department of Endemic and Parasitic Diseases Control and Prevention, Wanzhou District Center for Disease Control and Prevention, Chongqing 404199, China
  • Received:2025-05-26 Revised:2025-12-04 Published:2026-03-03
  • Contact: Zhou Shuang E-mail:15264835@qq.com

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摘要： 【摘要】 目的 了解重庆市新发麻风患者流行病学特征，评估不同化疗方案的疗效差异及影响因素。方法 本研究为回顾性队列研究。基于全国麻风病防治管理信息系统，回顾性调查2007—2020年重庆市3家区域性定点医院（巴南区、万州区、南川区皮肤病防治院）的216例新发麻风病例，收集患者基线资料、治疗方案及治疗中和治疗后随访数据。患者均使用利福平、氨苯砜、氯法齐明治疗，按疗程分为1年期组和2年期组。采用描述性统计分析麻风流行特征。通过Wilcoxon秩和检验及Pearson卡方检验或Fisher精确检验，比较1年期组与2年期组间的疗效差异。将联合化疗的效果分为较好和一般，运用Logistic回归模型分析疗效的影响因素。结果 共纳入216例患者，男156例（72.2%），女60例（27.8%），年龄13 ~ 100岁；分布在重庆市35个区县，以渝东北三峡库区城镇群［88例（40.7%）］为主；农民187例（86.6%）；初中及以下文化程度196例（90.7%）。2008年发现麻风病例最多，为27例（12.5%）；麻风延迟诊断期中位数781 d。1年期组119例（55.1%），2年期组97例（44.9%）。1年期组中，治疗中麻风反应发生率高于2年期组［27.7%（33/119）比15.5%（15/97），χ2 = 4.65，P = 0.031］，治疗后畸残加重发生率低于2年期组［4.2% （5/119）比13.4%（13/97），χ2 = 5.92，P = 0.015］。两组治疗效果为一般和较好的比例，差异无统计学意义（χ2 = 0.55，P = 0.458）。多因素Logistic回归分析显示，研究对象治疗前无麻风反应组获得较好治疗结局的概率是有麻风反应组的3.95倍（OR = 3.95，95% CI：1.97 ~ 8.22，P < 0.001）。结论 重庆市麻风病例多为偏远地区的中老年农民，1年期和2年期联合化疗的治疗效果相似，治疗前无麻风反应的患者可能取得较好的治疗效果。

关键词: 麻风, 联合化疗, 效果评估, 麻风反应, 重庆市, 疗程

Abstract: 【Abstract】 Objective To investigate the epidemiological characteristics of newly diagnosed leprosy patients in Chongqing, and to evaluate the efficacy of different multidrug therapy （MDT） regimens and factors associated with treatment outcomes. Methods A retrospective cohort study was conducted. Based on the National Leprosy Control Management Information System, 216 newly diagnosed leprosy patients were included from three regional designated hospitals （Hospitals of Dermatology Prevention and Treatment in Banan District, Wanzhou District, and Nanchuan District） in Chongqing between 2007 and 2020. Baseline information, treatment regimens, and follow-up data during and after treatment were collected. All patients received MDT （rifampicin, dapsone, and clofazimine）, and were divided into a 1-year MDT group and a 2-year MDT group based on the treatment duration. Descriptive statistics were used to analyze epidemiological characteristics; the Wilcoxon rank-sum test, Pearson's chi-square test, or Fisher's exact test was used to compare treatment outcomes between groups. The treatment outcome was categorized into two grades, i.e., favorable and moderate, and a logistic regression model was employed to analyze factors influencing efficacy. Results A total of 216 patients were included, comprising 156 males （72.2%） and 60 females （27.8%）, aged 13 to 100 years; these patients were from 35 districts and counties in Chongqing, and predominantly located in the urban clusters in the Three Gorges Reservoir Area in northeast Chongqing （88 cases, 40.7%）; most patients were farmers （187 cases, 86.6%）, and had education levels of junior high school or below （196 cases, 90.7%）. From 2007 to 2020, the number of reported cases （27 cases, 12.5%） in 2008 was the largest; the median diagnostic delay for leprosy was 781 days. Among the 216 patients, 119 （55.1%） underwent 1-year MDT, while 97 （44.9%） received 2-year MDT. The incidence of leprosy reactions during treatment was higher in the 1-year MDT group than in the 2-year MDT group （27.7% ［33/119］ vs. 15.5% ［15/97］, χ2 = 4.65, P = 0.031）, while the incidence of disability aggravation at the end of treatment was lower in the 1-year MDT group than in the 2-year MDT group （4.2% ［5/119］ vs. 13.4% ［13/97］, χ2 = 5.92, P = 0.015）. There was no significant difference in the proportion of patients achieving favorable or moderate outcomes between the two groups （χ2 = 0.55, P = 0.458）. Multivariate logistic regression analysis revealed that patients without leprosy reactions before treatment were 3.95 times more likely to achieve a favorable outcome than those with leprosy reactions before treatment （OR = 3.95, 95% CI: 1.97 - 8.22, P < 0.001）. Conclusions Leprosy patients in Chongqing were predominantly middle-aged and elderly farmers in remote areas. The therapeutic efficacy of 1-year MDT appeared comparable to that of 2-year MDT. Absence of leprosy reactions prior to treatment was associated with a higher likelihood of achieving favorable treatment outcomes.

Key words: Leprosy, MDT, Effectiveness evaluation, Leprosy reaction, Chongqing, Treatment course

引用本文

罗飞 石粤渝 肖鹏 狄林锦 罗升群 张信江 刘智勇 周爽. 2007—2020年重庆市麻风患者2年期与1年期联合化疗防治效果评估[J]. 中华皮肤科杂志, 2026,59(3):237-243. doi:10.35541/cjd.20250302

Luo Fei, Shi Yueyu, Xiao Peng, Di Linjin, Luo Shengqun, Zhang Xinjiang, Liu Zhiyong, Zhou Shuang. Comparison of efficacy of 2-year versus 1-year multidrug therapy for leprosy patients in Chongqing, 2007-2020[J]. Chinese Journal of Dermatology, 2026, 59(3): 237-243.doi:10.35541/cjd.20250302