【摘要】 麻风化疗后监测复发,是评价疗效和控制该病传播的主要途径。在细菌繁殖的初期,尚无明显复发症状时,仅靠每年一次的临床、细菌检查难以发现复发。为建立有效的疗后监测法,用适合现场的血清学试验和麻风菌素试验,对潍坊地区8县1658例麻风治愈者进行复发监测的前瞻性研究,以探讨免疫学试验监测复发的预测性。以PGL抗体(+),麻素反应(-)为复发危险因素,经筛检发现27例。其中危险组复发率为11％(23/210),对照组为0.28％(4/1447),相对危险度为39.5。筛检的结果反映了治愈者的免疫学状态,即愈后随时间推移,抗体逐渐消退和细胞免疫逐渐建立。MB治愈者PGL—IgM水平与麻素反应强度的负相关性提示,结合两指标不仅可反映机体免疫系统对麻风菌的清除力,而且为两指标结合筛检危险对象提供了理论依据。在27例复发中,多数复发时PGL—IgM水平已较高。监测中发现的7例复发,除PB复发外,余者在复发症状出现前1年半至2年半之间,已有PGL—IgM升高或持续升高。因此,对愈后时间较长、IgM水平较高,但无明显复发症状者,应予重点监测,观察PGL—IgM的动态变化。为提高监测PB复发的敏感性和可靠性,何合用PCR以协助早期诊断。更多还原

【Abstract】 To monitor leprosy relapse after completing MDT is the chief way of evaluating treatment and controlling the transmission of the disease.For studying predictability of leprosy relapse,1658 persons cured of leprosy have teen examined by using a serological test and lepromin reaction in eight counties,Weifang prefecture,Shandong province.Positivity of antibody to PGL plus negative reaction to lepromin is regarded as a hazardous factor.The hazard rate was 12.7 per cent (211/1685).During the three years of the monitoring 27 relapsed cases were detected,including 23 in the hazardous group and four in the controls,and the relapse rates were 11% and 0.28% respectively.The relative hazard degree was 39.5.The results showed that the antibody has been disappearing and CMI building up gradually in the cures as time goes on.The majority of the relapsed cases had a higher level of IgM antibody to PGL,one to one and a half years before relapse.The authors suggest that those who had gone through longer time after cured with higher IgM level should be the focal point in monitoring.更多还原