摘要
目的 分析麻风患者延迟发现及发生畸残的影响因素。方法 收集蒙自市麻风治愈存活病例及现症患者资料,对其进行描述性分析。延迟期比较采用非参数检验,畸残影响因素分析采用单因素及多因素Logistic回归分析。结果 共收集麻风治愈存活者及现症患者192例。中位延迟期为17(11~37.75)个月,不同文化程度、传染来源、发现方式、病期及神经损害数间延迟期差异有统计学意义(P<0.01)。文盲、家庭外感染、少菌型、延迟期>24个月、病期>11年、皮肤损害数≤5块是致畸残的危险因素(P<0.05)。1956—2020年,新发病例中Ⅱ级畸残比下降、延迟期、病期明显缩短(P<0.001),Ⅰ级畸残比上升(P<0.05),儿童发病比及其Ⅱ级畸残比变化无统计学意义(P>0.05)。结论 蒙自市麻风防治工作取得良好成效,但I级畸残及儿童发病问题值得重视。患者间延迟期差异较大,应继续加强麻风早期发现工作。文化程度、传染来源、型别、延迟期、病期及皮肤损害数是致畸残的影响因素,当地相关部门可据此制定针对畸残的预防措施。
Objective To analyze factors associated with delay diagnosis and disability in leprosy patients.Methods Data on the cured and existing leprosy cases in Mengzi City was collected for a descriptive analysis.Non-parametric tests were used for comparison on delay diagnosis.Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with disability in leprosy patients.Results A total of 192 cured and existing patients with leprosy were collected.The median delay diagnosis was 17(11-37.75)months.Significant differences in delay diagnosis were found among patients with different education levels,source of infection,detection modes,disease duration and nerve damage(P<0.01).Illiteracy,out of family infection,paucibacillary leprosy,delay diagnosis>24 months,disease duration>11 years,≤5 skin lesions were risk factors for disability(P<0.05).From 1956 to 2020,the percentage of gradeⅡdisability(GⅡD),delay diagnosis and disease duration among new leprosy cases decreased significantly(P<0.001),while the proportion of gradeⅠdisability(GⅠD)increased(P<0.05).Changes in the percentage of child cases and their GⅡD were not significantly different(P>0.05).Conclusion While great progress has been made in the prevention and control of leprosy in Mengzi City,the problems of GⅠD and child patients with leprosy remain and require further attention.Work on early detection of leprosy should be continuously strengthened as the delay diagnosis varies greatly from group to group.Education level,source of infection,leprosy type,delay diagnosis,disease duration and the number of skin lesions are influencing factors for disability,which has important implications for local authority to adopt tailored preventive measures.
作者
李爱玲
黄萍
熊燕
杨庆伟
王益民
LI Ailing;HUANG Ping;XIONG Yan;YANG Qingwei;WANG Yimin(Institute of Nutrition and Food Hygiene,School of Public Health,Lanzhou University,Lanzhou 730000,China;Department of Chronic Diseases,Mengzi City Center for Disease Prevention and Control,Mengzi 661100,China)
出处
《中国皮肤性病学杂志》
CAS
CSCD
北大核心
2024年第1期59-64,85,共7页
The Chinese Journal of Dermatovenereology
关键词
麻风
延迟期
畸残
影响因素
Leprosy
Delay diagnosis
Disability
Influencing factor
