多菌型麻风患者实施6个月联合化疗后4年疗效观察  

Four-year follow-up of multibacillary leprosy patients after six month treatment with uniform Multidrug therapy

作　　者：沈建平[1] 李进岚[2] 余美文[1] 周敏[1] 杨荣德 严良斌[1] 张国成[1] 

机构地区：[1]中国医学科学院、北京协和医学院皮肤病研究所,江苏南京210042 [2]贵州省疾病预防控制中心皮肤科,贵州贵阳550004 [3]文山州皮肤病防治所,云南文山州663000

出　　处：《临床皮肤科杂志》2013年第4期251-253,共3页Journal of Clinical Dermatology

基　　金：世界卫生组织的资助

摘　　要：目的:评价多菌型麻风患者实施6个月联合化疗后的远期疗效和麻风反应。方法:对79例多菌型麻风患者给予6个月的多菌型方案治疗,然后每年进行临床和细菌随访,连续4年,观察麻风反应发生率。结果:79例患者疗前细菌指数平均2.89±1.40,停药满1、2、3、4年时,细菌指数分别为0.97、0.71、0.38和0.21。细菌阴转率分别为36.7%、48.1%、68.4%和84.8%。研究中共有33例次发生麻风反应,反应频率为41.8%。研究期末累计发生Ⅰ、Ⅱ型反应的频率分别为17.7%和24.1%。该研究中在停止治疗后13个月,有1例患者因复发而退出研究。结论:接受6个月统一联合化疗的多菌型患者4年随防时疗效令人满意,与其他现场研究相比,细菌阴转率与常规联合化疗无差异。但麻风的复发仍需要进一步观察。Objective： To value the long-term effectiveness and leprosy reaction in multibacillary （MB） leprosy patients after 6 months of Uniform Multidrug Therapy （UMDT）. Methods： Seventy nine MB leprosy patients were treated with UMDT for 6 months, followed by annual clinical and bacteriological examinations including the total leprosy reaction rates for 4 years. Results： Of 79 MB leprosy patients, the mean bacterial index was 2.89＋1.40 before treatment. At the first, second, third and fourth years of follow-up, BI declined to 0.97, 0.71, 0.38 and 0.21, respectively while bacterial negative rates 36.7%,48.1%, 68.4% and 84.8%, respectively. There were 33 （41.8%） leprosy reactions, in which type I and II reactions 17.7% and 24.1%, respectively. One patient dropped out of this study due to leprosy relapse 13 months after stopping treatment. Conclusions： During the four-year follow-up, the effectiveness of UMDT in treating MB leprosy patients is satisfying. There is no significant difference in bacterial negative rates of UMDT compared to that of routine multidrug therapy reported by others. However, patients treated with UMDT need to be further follow-up for the relapse.

关 键 词：麻风 统一联合化疗 细菌指数 复发 

分 类 号：R755[医药卫生—皮肤病学与性病学]