2021年度山东省麻风症状监测结果分析

Analysis of leprosy symptomatic surveillance in Shandong Province in 2021

背景:2020年,山东省顺利完成《全国消除麻风危害规划(2011-2020年)》终期评估目标,新发麻风2级畸残比下降至14%。鉴于麻风潜伏期较长,通过症状监测等措施持续加强麻风病例早期发现对巩固达标成果尤为必要。目的:本文对2021年山东省新确诊的麻风病例进行分析,总结达标后麻风早期发现的防治成效。方法:依托全省182家皮肤病专科联盟单位开展麻风症状监测,将麻风疑似病例或不能排除麻风的疑难少见病例转诊至山东省皮肤病性病防治研究所确诊或排除,确诊麻风病例均在省所接受规范化诊疗。采用SPSS16.0统计软件进行统计分析,数值变量用(均数±标准差)描述,分类变量用率或构成比描述。结果:2021年全省皮肤病专科联盟单位共转诊麻风疑似病例和疑难少见皮肤病病例623例,最终确诊麻风12例,其中新发11例,复发1例,新发麻风病例2级畸残比降至9%,创历史新低。新确诊病例麻风反应发生率为75%,联合糖皮质激素、免疫抑制剂和生物制剂的治疗效果较好。结论:依托综合医疗机构皮肤科和皮防机构开展麻风症状监测是早期发现麻风病例、预防畸残发生和持续巩固达标成果的关键措施。

Background:In 2020,Shandong Province achieved the goals of the National Plan for the Elimination of Leprosy Hazards(2011-2020),and the rate of grade 2 disability(G2D)among newly detected cases decreased to 14%.In view of the long incubation period of leprosy,it is necessary to continuously strengthen early detection of leprosy cases through symptomatic surveillance and other measures to consolidate the achievement of goals.Objective:We analysed the newly diagnosed leprosy cases in Shandong Province in 2021,and summarized the leprosy control and prevention effects after achieving the targets.Methods:Leprosy symptomatic surveillance was preformed through 182 dermatology specialized alliance units.Suspected leprosy cases or skin diseases cases that can t be diagnosed were referred to Shandong Provincial Institute of Dermatology and Venereology(SPIDV)for confirmation or elimination of leprosy.All confirmed leprosy cases received multidrug therapy in SPIDV.Statistical analysis was performed using SPSS16.0.Numerical variables were described using mean±standard deviation,and categorical variables were described using rates.Results:In 2021,a total of 623 suspected leprosy cases or skin diseases cases that can t be diagnosed were referred to SPIDV.12 patients were diagnosed as leprosy,including 11 newly detected cases and 1 relapsing case.The G2D of new leprosy cases decreased to a record low of 9%.Leprosy reaction was 75%among 12 cases,and the combination of prednisone,immunosuppressant,and biologics has better therapeutic effect.Conclusion:Symptomatic surveillance of leprosy by relying on dermatologists in general hospitals and leprosy prevention institutes is necessary to early detect of potential leprosy cases,prevent disability of cases and consolidate the achievement of targets.