贵州省81例麻风不良反应特征及相关因素分析

Analysis of Adverse Reactions and Related Factors in 81 Cases of Leprosy in Guizhou Province

目的了解麻风不良反应的发生特征及相关因素。方法对贵州省81例登记麻风不良反应的麻风患者病历资料进行回顾性分析。结果81例不良反应麻风患者中,Ⅰ型麻风反应12例(14.81%),Ⅱ型麻风反应41例(50.62%),混合型麻风反应9例(11.11%),单纯神经炎19例(23.46%)。40例(49.38%)麻风反应发生在联合化疗治疗前,26例(32.10%)发生在联合化疗中,15例(18.52%)发生在完成联合化疗后;Ⅰ型麻风反应、单纯神经炎发生多在开始MDT治疗1年内,Ⅱ型麻风反应多发生在MDT治疗结束后。神经损害均以双侧为主,尺神经炎发生率最高,为53.85%,麻风不良反应的发生与细菌指数有关(P<0.05)。结论需进一步提高麻风不良反应的早期诊断水平,BI≥2.0的麻风患者、MDT治疗期间及治完后都要密切监测麻风不良反应的发生以减少麻风残疾的发生。

Objective To understand the characteristics and related factors of adverse reactions on leprosy.Methods A retrospective analysis of the medical records of 81 cases of leprosy patients with leprosy adverse reactions.Results Among 81 cases of ADR leprosy,12 cases(14.81%) had type Ⅰ leprosy reaction,41 cases(50.62%) had type Ⅱ leprosy reaction,9 cases(11.11%) had mixed leprosy reaction and 19 cases(23.46%) had simple neuritis.Forty cases(49.38%) of leprosy occurred before multi-drug therapy(MDT),26 cases(32.10%) occurred in MDT,and 15 cases(18.52%) occurred after MDT.Type Ⅰ leprosy reaction and simple neuritis mostly occurred within one year after starting MDT treatment,and type Ⅱ leprosy reaction occurred mostly after MDT treatment.The nerve damage was mainly bilateral,and the incidence of ulnar neuritis was the highest at 53.85%.The occurrence of adverse reactions of leprosy was related to bacterial index(P<0.05).Conclusion It is necessary to further improve the early diagnosis of adverse reactions of leprosy.The incidence of adverse reactions of leprosy should be closely monitored in leprosy patients with BI(≥2.0),during and after MDT treatment.