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界线类偏结核样型麻风:多药联合治疗的临床病理评估

BORDERLINE TUBERCULOID LEPROSY: CLINICOPATHOLOGICAL EVALUATION OF MULTIDRUG THERAPY.

作者信息

Kar P K, Dhaka R S

机构信息

Classified Specialist (Dermatology & Ven), 151 Base Hospital C/O 99 APO, Pune.

Classified Specialist (Pathology), Military Hospital Jalandhar Cantt 144004.

出版信息

Med J Armed Forces India. 1997 Apr;53(2):91-94. doi: 10.1016/S0377-1237(17)30673-1. Epub 2017 Jun 26.

Abstract

Efficacy of multi-drug therapy as per WHO recommendation in 125 fresh cases of borderline tuberculoid (BT) leprosy was evaluated. There were 116 (92.8%) male and 9 (7.2%) female patients. Age of the patients ranged from 18-50 years but the majority (80.8%) were young adults in the age group 21-35 years. The commonest site of lesion was the upper extremity in 65 (52%) cases. Skin smear for acid fast was positive in 11 (8.8%) patients. All patients were given multidrug therapy consisting of rifampicin 600 mg once a month and dapsone 100 mg daily for 6 months. At the end of 6 months, 42 (33.6%) patients had shown marked improvement, 14 (11.2%) had increase in activity, 51 (45.6%) had shown regression and 12 (9.6%) cases became clinically inactive. Histologically complete clearance of the infiltration was not observed in any patient. Compact granulomas persisted in 30 (24%) cases. In 1 (0.8%) patient were found in the skin smear at the end of 6 months. This study indicates that treatment with MDT for 6 months is inadequate to treat all types of BT leprosy cases.

摘要

对按照世界卫生组织建议采用多药疗法治疗的125例新诊断的界线类偏结核样型(BT)麻风病例的疗效进行了评估。其中男性患者116例(92.8%),女性患者9例(7.2%)。患者年龄在18至50岁之间,但大多数(80.8%)为21至35岁的年轻人。最常见的皮损部位是上肢,共65例(52%)。11例(8.8%)患者的抗酸皮肤涂片呈阳性。所有患者均接受了多药疗法,即每月服用一次600毫克利福平,每日服用100毫克氨苯砜,疗程为6个月。6个月末,42例(33.6%)患者有明显改善,14例(11.2%)病情活动度增加,51例(45.6%)病情出现好转,12例(9.6%)临床症状消失。组织学上,未观察到任何患者的浸润完全清除。30例(24%)患者仍有致密肉芽肿。6个月末,1例(0.8%)患者的皮肤涂片仍呈阳性。本研究表明,采用多药疗法治疗6个月不足以治愈所有类型的BT麻风病例。

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