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多药联合治疗下少菌型麻风的临床评估——三年随访研究

Clinical assessment of paucibacillary leprosy under multidrug therapy-three years followup study.

作者信息

Revankar C R, Karjivkar V G, Gurav V J, Ganapati R

机构信息

Bombay Leprosy Project Vidyan Bhavan.

出版信息

Indian J Lepr. 1989 Jul;61(3):355-9.

PMID:2768883
Abstract

408 skin smear negative paucibacillary leprosy cases who had completed six months MDT were kept under surveillance for three years. The clinical assessment at the end of surveillance showed that 276 (82%) of all the cases attained inactivity. Two patients who were inactive showed signs of relapse. Five patients showed more activity though they were regressing under treatment. The inactivity rate was much higher amongst the patients with 1 to 3 skin lesions (88%) as compared to the patients with greater than or equal to 4 lesions (60%). The difference was statistically significant (P less than 0.001). The past treatment before MDT did not appear to influence the clinical course of the disease. 17% of the patients essentially border-line type continued to show signs of activity even after 3 years surveillance indicating the need for triple drug therapy (to be treated as multibacillary). However large scale data on relapse rate would be essential before the efficacy of WHO short-term therapy for paucibacillary leprosy is evaluated.

摘要

408例已完成6个月多药联合化疗的皮肤涂片阴性少菌型麻风病例接受了3年的监测。监测结束时的临床评估显示,所有病例中有276例(82%)病情静止。2例病情静止的患者出现了复发迹象。5例患者尽管在治疗过程中病情有所好转,但仍表现出较多的活动症状。与有4个及以上皮损的患者(60%)相比,有1至3个皮肤损害的患者静止率要高得多(88%)。差异具有统计学意义(P小于0.001)。多药联合化疗之前的既往治疗似乎并未影响疾病的临床进程。17%的基本为边缘型的患者即使经过3年监测仍继续表现出活动症状,这表明需要采用三联药物疗法(按多菌型治疗)。然而,在评估世界卫生组织针对少菌型麻风的短期疗法的疗效之前,关于复发率的大规模数据至关重要。

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