Shen Jianping, Liu Musang, Zhou Min, Li Wenzhong
Department for Leprosy Control, National Center for Leprosy Control, Chinese Academy of Medical Sciences, Nanjing, Jiangsu, China.
Int J Dermatol. 2011 Jan;50(1):57-60. doi: 10.1111/j.1365-4632.2010.04593.x.
We analyzed the causes of death among active leprosy patients in China, to better understand the disease and improve the quality of services, by performing a retrospective study involving 24 provinces of China. Information about patients with active leprosy who were not clinically cured and died between January 1, 2000, and December 31, 2005, was collected by professionals at county levels. A total of 524 deaths were analyzed. The leading cause of death was suicide. There were 86 patients (16%) who died at a mean of 21 ± 19 months after starting multi-drug therapy (MDT). The second and third leading causes of death were cardiovascular disease and organ failure associated with advanced age, respectively. Two hundred and twenty-one patients (42%) died within one year of beginning MDT. The second month of MDT was the riskiest for newly treated patients; approximately 20% of patients succumbed to liver failure, 33% to dapsone (diaminodiphenylsulfone/DDS) allergy, and 27% to renal insufficiency during this period. Among 143 deaths related to leprosy, 37 (26%) occurred within three months of starting MDT. We recommend that newly diagnosed patients should be provided with no more than two months of MDT blister packs.
我们通过一项涉及中国24个省份的回顾性研究，分析了中国活动性麻风病患者的死亡原因，以更好地了解该疾病并提高服务质量。县级专业人员收集了2000年1月1日至2005年12月31日期间未临床治愈并死亡的活动性麻风病患者的信息。共分析了524例死亡病例。主要死亡原因是自杀。有86例患者（16%）在开始多药联合化疗（MDT）后平均21±19个月死亡。第二和第三大死亡原因分别是心血管疾病和与高龄相关的器官衰竭。221例患者（42%）在开始MDT的一年内死亡。MDT的第二个月对新治疗的患者来说风险最大；在此期间，约20%的患者死于肝功能衰竭，33%死于氨苯砜（二氨二苯砜/DDS）过敏，27%死于肾功能不全。在143例与麻风病相关的死亡病例中，37例（26%）发生在开始MDT的三个月内。我们建议为新诊断的患者提供不超过两个月的MDT泡罩包装。
