摘要
对1515例麻风治愈者以酶联免疫吸附试验(ELISA),用全血滤纸干渍斑,连续5年检测其麻风菌特异抗体酚糖脂—免疫球蛋白M(PGL—IgM)。对第一年检测阳性者(281例)随机分成A、B两组:A组(140例)每年仅进行一次临床、细菌和免疫学监测;B组(141例)给MDT一年,以后继续监测;阴性者为C组(1234例),每年一次临床、细菌和免疫学监测。第一年检测发现随着型别TT→LL,阳性率逐渐升高;治愈时间越短,阳性率越高。五年监测共发现20例复发,其中A组复发率为11.4％(16/140),B组为0.71％(1/141),C组为0.24％(3/1234)。抗体阳性者的相对危险度为47(16/140/3/1234)。抗体阴性者复发明显低于阳性者(P<0.001);抗体阳性者用MDT一年的抗复发组复发率明显低于不治疗组(P<0.001)。故在现场用定期免疫学监测,对抗体阳性者给以抗复发治疗,可节省人力和经费,有推广价值。
ELISA with dried blood spot on filter paper has been used to find anti -PGL IgM antibody special to M. leprae for five years in succession in Shandong Province. 281 persons with ELISA positivity in the first test were randomly divided into two groups;group A,including 140 persons, was only examined one time a year and group B,having 141 persons, was given WHO's MDT in one year besides the examination. 1234 persons with negativity served as control. In the first test,it was found that the positive rate gradually increased with TT to LL in the classification spectrum, and that the shorter the time of being cured, the higher the positive rate. And during the five year monitoring twenty relapsed cases were detected,of which 16 belong to group A,making up 11. 4%, one to group B (0. 71%) and three to Group C (0. 24%). The relative risk was 47 for those with ELISA positively who did not take MDT,but those who had taken one year MDT have borne only much lower risk of relapse. The authors regard the method of monitoring relapse as being worthy to be popularized.
