中华皮肤科杂志 ›› 2010, Vol. 43 ›› Issue (2): 75-78.

• 论著 •    下一篇

麻风患者166例统一联合化疗后2年随访

沈建平1,李文忠1,周敏2,牟鸿江3,包夏3,杨荣德4,王娟4   

  1. 1. 南京 中国医学科学院北京协和医学院皮肤病研究所
    2. 南京市医科院皮研所
    3. 贵州省疾病预防控制中心
    4. 云南省文山州皮肤病防治所
  • 收稿日期:2009-03-13 修回日期:2009-04-16 出版日期:2010-02-15 发布日期:2012-03-30
  • 通讯作者: 沈建平 E-mail:jianping_shen2@yahoo.com.cn
  • 基金资助:
    不符合上述请自行填写具体基金资助项目名称（编号）

A 2-year follow-up study on 166 leprosy patients treated with uniform multidrug therapy

  • Received:2009-03-13 Revised:2009-04-16 Online:2010-02-15 Published:2012-03-30

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摘要： 目的 探讨6个月麻风统一联合化疗方案对各型麻风患者的疗效。方法 对166例各型麻风患者采取世界卫生组织多菌型方案治疗6个月，观察临床和细菌学方面的疗效。结果 在166例患者中因各种原因退出31例，完成治疗并随访2年的患者135例。135例疗前查菌阴性者为45例（33.3%），其余90例患者细菌指数从0.1 ~ 6.0不等，细菌指数疗前平均为2.91 ± 1.45，在停止治疗第2年末，45例细菌阴性患者显示总的皮损消退和改善率达到93.3%。神经体征改善率达80.0%。在90例查菌阳性患者中，皮肤损害消退和改善率达95.6%，神经改善率达77.8%。疗前细菌阳性的90例患者中有49例患者细菌阴转，占54.4%，平均细菌指数降低为0.66 ± 0.99。从开始治疗后的2.5年中，平均每年下降 0.9。在完成治疗停药随访满2年的135例患者中有25例发生麻风反应。其中Ⅰ型和Ⅱ型反应分别为13例和12例。在166例患者中，有1例多菌型患者在停止治疗后13个月复发。结论 统一联合化疗的近期疗效与常规MDT方案治疗2年的结果相似，其反应发生率差异以及远期复发率尚待观察。

关键词: 麻风, 复发, 药物疗法，联合

Abstract: Objective To assess the efficacy of 6-month uniform multidrug therapy in various types of leprosy. Methods A field trial was conducted among 166 patients with different types of leprosy. All patients were treated with uniform multidrug therapy for 6 months, then followed up for 2 years. Clinical and bacteriological improvements were evaluated. Results Among the 166 patients, 31 dropped out due to various reasons, and 135 completed the 6-month treatment and 2-year follow-up. Among the 135 patients, 45 （33.3%） were skin smear negative, and the other smear-positive 90 had an average bacterial index （BI） of 2.91 ± 1.45 （range: 0.1 - 6.0） before treatment. At the end of the 2-year follow-up, the 45 skin smear-negative patients showed 93.3% improvement in skin lesions and 80.0% improvement in nerve impairments, and the smear-positive 90 patients showed 95.6% improvements in skin lesions and 77.8% improvement in nerve impairments. Skin smear turned negative in 49 （54.4%） out of the smear-positive 90 patients with the average BI declining to 0.66 ± 0.99. The annual decrease in BI reached 0.9 during the first 2.5 years after the beginning of treatment. Twenty-five patients developed leprosy reaction during the follow-up, including 13 cases of type I leprosy reaction and 12 cases of type II leprosy reaction. Relapse was noted in 1 patient with multibacillary leprosy 13 months after the termination of treatment. Conclusions The short-term efficacy of uniform multidrug therapy is similar to that of 2-year treatment with routine multidrug therapy. However, further studies are required to survey the incidence of leprosy reaction and relapse in patients treated with uniform multidrug therapy.

Key words: recurrence