108例麻风病患者2级畸残情况及相关因素分析

Analysis of grade 2 disability status and related factors in 108 leprosy patients

目的探究麻风病患者2级畸残(grade 2 disability,G2D)情况及其影响因素,为制定麻风病预防和控制策略提供依据。方法通过全国麻风病防治管理信息系统收集2000年1月—2023年1月南宁市疾病预防控制中心新发现的108例麻风病患者资料,根据是否发生G2D分为畸残组(30例)和非畸残组(78例)。采用单因素和多因素回归分析麻风病患者发生G2D的危险因素。结果单因素分析结果显示,性别(χ^(2)=4.226,P=0.040)、延迟期(χ^(2)=13.633,P=0.001)、皮损数量(χ^(2)=23.222,P<0.001)、周围神经粗大/触痛条数(χ^(2)=35.244,P<0.001)、麻风反应(χ^(2)=11.353,P=0.001)是麻风病患者发生G2D的危险因素;多因素回归分析结果显示,性别(OR=0.108,95%CI:0.020~0.588)、延迟期≥24个月(OR=6.124,95%CI:1.133~33.094)、周围神经粗大/触痛≥2条(OR=13.173,95%CI:1.602~38.315)、有麻风反应(OR=4.205,95%CI:1.216~14.544)是麻风病患者发生G2D的独立危险因素。结论麻风病患者发生G2D的高危因素为男性、延迟期长、有周围神经粗大/触痛以及出现麻风反应。麻风病畸残仍是全球疾病负担,应加强各医疗机构对麻风病诊断、治疗及随访,消除麻风病危害,提高麻风病防治质量。

Objective To explore the situation of grade 2 disability(G2D)status in leprosy patients and its influencing factors,and to provide a basis for the formulation of leprosy prevention and control strategies.Methods The data of 108 newly detected leprosy patients in Nanning Center for Disease Control and Prevention from January 2000 to January 2023 were collected from the national leprosy management prevention and treatment information system.The leprosy patients were divided into a disability group(30 cases)and a non-disability group(78 cases)according to the occurrence of G2D or not.Univariate and multifactorial regression analysis were used to analyze the risk factors for the occurrence of G2D in leprosy patients.Results The results of univariate regression analysis showed that gender(χ^(2)=4.226,P=0.040),delay period(χ^(2)=13.633,P=0.001),the number of skin lesions(χ^(2)=23.222,P<0.001),the number of thick/tender peripheral nerves(χ^(2)=35.244,P<0.001),leprosy reaction(χ^(2)=11.353,P=0.001)were the risk factors for the occurrence of G2D in leprosy patients.The results of multifactorial regression analysis showed that gender(OR=0.108,95%CI:0.02-0.588),delayed period≥24 months(OR=6.124,95%CI:1.133-33.094),number of thicker/tender peripheral nerves≥2(OR=13.173,95%CI:1.602-38.315)and presence of a leprosy reaction(OR=4.205,95%CI:1.216-14.544)were independent risk factors for the occurrence t of G2D in leprosy patients.Conclusion The high-risk factors for the occurrence of G2D in leprosy patients are male,long delay period,presence of thick/tender peripheral nerves and the occurrence of leprosy reaction.Leprosy deformity is still a global disease burden.It is necessary to strengthen the diagnosis,treatment and follow-up of leprosy in medical institutions,eliminate the harm of leprosy,and improve the quality of leprosy prevention and treatment.