作　　者： (刘杨英）; (余美文）; (宁湧）; (王皓）;

机构地区： 四川省医学科学院·四川省人民医院皮肤病性病研究所,四川成都610031

出　　处： 《临床皮肤科杂志》 2017年第9期613-616,共4页

摘　　要： 目的:了解四川省儿童麻风的流行病学及临床特征。方法:回顾性分析2000—2015年四川省儿童(≤14岁)麻风流行病学和临床资料,进行描述和比较性分析。结果:共新发现麻风患者2900例,新发患者中儿童总数为73例,占新发病例总数2.52%;患儿主要分布在高流行地区凉山州和甘孜州;患儿确诊时平均年龄(11.60±1.73)岁,平均延迟期为(1.05±1.23)年;男女比例为2.32∶1,1级畸残和2级畸残(G2D)分别为4例(5.48%)和5例(6.85%)。39例(53.42%)患儿查菌阳性,65例(89.04%)患儿采用多菌型联合化疗(MDT-MB)治疗方案;48例(65.75%)患儿传染来源于家庭内,患儿最主要的发现方式是接触者检查;临床分型以界线类偏结核样型麻风(BT)22例(30.13%)、界线类偏瘤型麻风(BL)18例(24.66%)和瘤型麻风(LL)15例(20.55%)为主。10例(13.70%)患儿为单个皮损,26例(35.62%)患儿有2~5处皮损,37例(50.68%)患儿有5处以上的皮损,皮损主要分布于躯干36例(49.32%),其次为下肢29例(39.73%),上肢28例(38.36%),面部14例(19.18%);外周神经受累者56例(76.71%),其中42例(57.53%)有2条以上的神经受累,14例(19.18%)单条神经受累。确诊后随访中14例(19.18%)患儿发生了麻风反应,其中10例为1型反应,4例为2型反应。结论:儿童麻风会在较长时间内持续存在。儿童麻风临床上以多皮损和多条神经受累表现为主,应警惕儿童麻风反应和神经炎的发生。需重视家属接触者检查,促进儿童麻风的早期发现。 Objectives： To study the epidemiological and clinical characteristics of childhood leprosy in Sichuan province be- tween 2000 and 2015. Methods： A retrospective study was adopted to analyze the epidemiological and clinical data of children （≤ 14 years old） with leprosy in descriptive and comparative ways. Results： A total of 2900 new cases of leprosy, including 73 （2.52%） children, were diagnosed in Siehuan province between 2000 and 2015. Most of the children were from high-epidemic area, including Liangshan and Ganzi prefectures. The mean age of the patients was 11.60±1.73 years, with a male to female ratio of 2.32：1. On average, the diagnosis was delayed 1.05±1.23 years. The grade 1 and grade 2 disability（G2D） were 4（5.48%） and 5 cases（6.85%）, respectively. 39（53.42%） patients were positive skin smears 65（89.04%） cases were under the treatment of MDT-MB. 48（65.75%） patients were infected by contact with infected family members. Numbers of patients with different type of leprosy arranged in decent order were Borderline Tuberculoid leprosy（BT）（22 cases, 30.13%）, Borderline Lepromatous leprosy（BL）（18 cases, 24.66%）, and Lepromatous leprosy（LL）（15 cases, 20.55%）. A single lesion was observed in 10（13.70%） patients. 26 （35.62%） patients had 2-5 lesions while 37（50.68%） patients had more than five lesions. Lesions were on the trunk in 36 （49.32%） children, lower extremity in 29（39.73%）, upper extremity in 28（38.36%） children and face in 14（19.18%） children. Thickened peripheral nerves were present in 56（76.71%） children, including 42（57.53%） cases with more than one thickened nerves and 14（19.18%） cases with one nerve involved. Leprosy reactions were observed in 14（19.18%） cases, including 10 Type 1 and 4 Type 2 leprosy reactions. Conclusions： Childhood leprosy carl exist for a long time. Multiple lesions and multiple nerve involvement are the clinical features of childhood leprosy. Caution should be take

关 键 词： 麻风 儿童 流行病学特征 临床特征