2000—2019年广东省新发麻风病例2级畸残情况及影响因素分析

Grade 2 disability and its associated risk factors in leprosy patients in Guangdong province,China,2000-2019

目的:了解广东省新发麻风病例2级畸残情况及其影响因素,为麻风病防控提供理论依据。方法:从《全国麻风病防治管理信息系统(LEPMIS)》中收集广东省2000—2019年报告的新发麻风病例资料,建立数据库并经逻辑检错后,用SPSS 20.0软件进行统计分析。人口学特征、临床信息、畸残情况等采用描述性分析,畸残情况的影响因素采用Logistic回归分析。结果:共收集2000—2019年1985例新发麻风病例资料,60岁及以上者占40.26%(798/1982),平均年龄为(54.33±18.25)岁。已婚占72.19%(1015/1406),广东籍占84.03%(1668/1985),汉族占95.82%(1902/1985),职业主要为农牧民(60.59%,1144/1888),文化程度主要为小学及以下(43.28%,544/1257)。2级畸残比例为18.29%(363/1985)。多因素Logistic回归显示2级畸残的危险因素包括男性(OR=2.61,95%CI:1.63~4.20)、汉族(OR=5.90,95%CI:1.70~20.53)、延迟诊断(OR=4.00,95%CI:2.67~5.98)、体重过低(OR=4.63,95%CI:2.06~10.42)和确诊时有神经损害(OR=31.94,95%CI:9.95~102.58)。结论:导致麻风病患者发生畸残的因素较为复杂,主要因素有麻风病例延迟诊断期的长短、身体健康状况以及神经损害情况等。各级医疗机构应加强对麻风病疑似症状的筛查,早发现、早诊断、早治疗,降低新发麻风病畸残比例,提高麻风病例生活质量。

Objective:To investigate the rate of grade 2 disability(G2D)in leprosy patients and its associated risk factors in Guangdong in order to provide a basis for the development of integrated preventive and control strategy.Methods:Data of new leprosy patients in Guangdong province from 2000-2019 were collected from leprosy management information system in China(LEPMIS),and analyzed using SPSS 20.0 software.Descriptive analysis was used for socio-demographic characteristics and disability,while Logistic regression analysis was used for risk factors of G2D in leprosy patients.Results:A total of 1985 cases,aged 54.33±18.25 years,were analyzed.Over forty percent of patients(798/1982)were≥60 years old.Majority of the patients were married(1015/1406,72.19%).Native Cantonese and Han accounted for 84.03%(1668/1985)and 95.82%(1902/1985),respectively.Over sixty percent of patients(1144/1888)were farmers.Five hundred forty four out of 1257 patients(43.28%)had education level of elementary school or lower.Rate of subjects with G2D was 18.29%(363/1985).Multivariate analysis showed that risk factors for G2D included male(OR=2.61,95%CI:1.63~4.20),the Han nationality(OR=5.90,95%CI:1.70~20.53),delayed diagnosis(OR=4.00,95%CI:2.67~5.98),low body weight(OR=4.63,95%CI:2.06~10.42),and nerve damage at the initial diagnosis(OR=31.94,95%CI:9.95~102.58).Conclusions:The factors associated with disability in leprosy patients are complex,and the main factors include delayed diagnosis,health status and nerve damage.It is necessary to strengthen the screening of patients with suspected symptoms of leprosy in clinics at all levels.Early diagnosis and treatment of leprosy can reduce the risk of disability and improve the quality of life of leprosy patients.