摘要
对山东省部分县市在1958～1990年治愈的20091例麻风患者,进行复发的回顾性调查,对原为MB的7289例,观察了71175.5人年,复发461例,复发率为6.48/1000人年;对原为PB的12802例。观察160079人年,复发678例,复发率为4.29/1000人年。复发与治疗用药关系密切,MB单用DDS的5628例中复发446例(7.92％),用DDS+RFP治疗的1405例中复发15例(1.07％)(U=9.28,P<0.001);PB单用DDS10903例中复发589例(5.4％),单用TB1的763例中复发96例(12.6％)(U=8.16,P<0.001);用DDS+RFP的1101例中复发2例(0.18％),非常显著地低于前二者(U=7.70,11.80,P<0.001).用DDS+RFP+B663治疗的MB256例和PB 35例,均无一例复发,治愈后15年内复发者,在MB复发者中为96.3％,PB中为90.1％,大多数复发者单用DDS治疗仍然有效,可再次治愈(MB 23/282,PB 396/399),作者认为,对用非MDT治愈者,愈后监测不应少于15年,对其中60岁以下者,可考虑用短程MDT复治,以减少复发。
A retrospective analysis with life-table method on the relapse in 20091 cured cases of leprosy from 1955 to 1990 in Shandong province is presented.The result showed that the relapse was relevant to the drugs used in the treatment.The relapse rates in MB and PB were 6.84 and 4.29/1000 person years respectively.In MB patients treated with DDS and DDS plus RFP they were 7.92% (446/5628) and 1.07% (15/1405) respectively and in PB treated with thiacetazone,DDS and WHO-MDF 12.6%(96/763),5.4%(589/10903) and 0.18%(2/1101) respectively,being significantly lower in the group of WHO-MDT(p<0.001).The most important was that there was no relapse in 256 MB and 35 PB cases treated with WHO-MDT.96.3% of the relapses in MB and 90.1 % in PB occured within 15 years after cured and the drug used in them mainly was DDS in monotherapy but DDS still is effective in re-treatment for them.The authors suggest that the follow-up period should not be less than 15 years for those cured with DDS monotherapy and some short-term MDT would be given to them in order to prevent the relapse.
