2009—2020年贵州省儿童麻风流行病学及临床特征分析  

Epidemiology and clinical characteristics of leprosy in children in Guizhou,2009—2020

作　　者：周姣姣 马晓雪 刘洁[2] 洪峰[1] 李进岚 ZHOU Jiao-jiao;MA Xiao-xue;LIU Jie;HONG Feng;LI Jin-lan(The Key Laboratory of Environmental Pollution Monitoring and Disease Control,Ministry of Education School of Public Health,Guizhou Medical University,Guiyang,Guizhou 550025,China)

机构地区：[1]贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州贵阳550025 [2]贵州省疾病预防控制中心结防所

出　　处：《现代预防医学》2022年第5期769-772,788,共5页Modern Preventive Medicine

基　　金：国家自然科学基金(81260436)。

摘　　要：目的了解贵州省儿童麻风的临床及流行病学特征,为今后儿童麻风防治工作提供参考依据。方法收集2009—2020年新发现儿童患者流行病学和临床资料,并将信息录入Excel电子表格建立数据库,对其进行回顾性地描述分析,组间比较采用χ^(2)检验。结果2009—2020年共新发现麻风患者1748例,其中儿童62例,儿童比为3.55%。2012年后儿童比和发现率呈明显下降趋势;2级畸残患者7例,占11.29%,2013年后发现的儿童患者无2级畸残;患者确诊时平均延迟期(13.26±12.29)个月,延迟期在不同的传染来源中差异有统计学意义(χ^(2)=6.326,P<0.05);主动发现患者52例(83.87%),以家庭内密切接触者检查发现(59.67%)的患者最多。型比MB∶PB=1∶1 h,少数民族的MB型构成比62.86%高于汉族的33.33%,差异有统计学意义(χ^(2)=5.314,P<0.05)。神经受累≥2条神经损害的患者42例(67.70%);55例神经受累部位记录的患者,周围神经受损有尺神经42例(76.36%)、耳大神经21例(38.18%)、腓总神经25例(45.45%)。有28例(45.16%)患者皮损>5块,主要有红斑28例(50.91%)、浅色斑26例(47.27%)、结节12例(21.82%)。结论贵州省儿童麻风患者发现提示部分县区麻风传播链仍然存在,临床上以多皮损和多神经受累为主,应坚持麻风家内接触者定期随访措施和促进皮肤科麻风可疑症状监测工作,提高患者的早期发现,建议实施麻风家内密切接触者化学预防服药,打破传染链,以期实现"零"新发患者目标。Objective To understand the clinical and epidemiological characteristics of childhood leprosy in Guizhou Province,and to provide reference for the prevention and control of childhood leprosy in the future.Methods The epidemiological and clinical data of newly discovered children from 2009 to 2020 were collected,and the information was inputted into Excel spreadsheet to establish a database for retrospective description and analysis.χ^(2)test was used for comparison between groups.Results From 2009 to 2020,1748 new leprosy patients were found,including 62 children,with a child-to-adult ratio of3.55%.After 2012,the ratio of children and the discovery rate showed a significant downward trend.There were 7 patients with grade 2 deformity,accounting for 11.29%.The child patients found after 2013 had no grade 2 deformity and the average of diagnosis delay was(13.26±12.286)months.There was significant difference in the delay among different sources of infection(χ^(2)=6.326,P<0.05).52 patients(83.87%)were found actively,and the most patients were found by close contacts in the family(59.67%).The type ratio MB:PB was 1:1.The MB type composition ratio of ethnic minorities was62.86%,which was higher than that of Han nationality,33.33%,and the difference was statistically significant(χ^(2)=5.314,P<0.05).42 patients(67.70%)with nerve involvement≥2 nerves,in 55 patients with nerve involvement,42 cases(76.36%)of ulnar nerve,21 cases(38.18%)of greater auricular nerve and 25 cases(45.45%)of common peroneal nerve were damaged.There were 28 cases(45.16%)with more than 5 lesions,mainly erythema in 28 cases(50.91%),light spots in 26 cases(47.27%)and nodules in 12 cases(21.82%).Conclusion The discovery of children with leprosy in Guizhou Province suggests that the leprosy transmission chain still exists in some counties and regions.Clinically,it is mainly multi skin lesions and multi nerve involvement.We should adhere to the regular follow-up measures of leprosy home contacts and promote the monitoring of suspected leprosy sympto

关 键 词：麻风病 儿童 流行病学特征 临床特征 

分 类 号：R181.3[医药卫生—流行病学] R755[医药卫生—公共卫生与预防医学]