云南省新发及治疗麻风病例的临床与病理关系

发布时间：2018-06-26 03:59

  本文选题：麻风 + 组织病理　； 参考：《昆明医科大学》2015年硕士论文

【摘要】：目的：探讨新发麻风病例临床表现及病理特点；对麻风治疗患者(治疗疗程已足)进行监测,观察临床表现变化及治疗后病理改变特点,评估治疗效果,判断是否到达临床治愈。方法：收集于我院诊断及复查的麻风病人79例,回顾性分析临床资料；对收集组织蜡块切片后做HE染色和抗酸染色,观察病理特点。根据收集的临床和病理资料进行统计分析。结果：在新发病例中麻风患者不同麻风分型、菌量对应的年龄无统计学意义；病理分型与麻风分型不一致率为10%,不一致的患者病理表现为非特异性炎症改变。麻风分型与GF(肉芽肿分数)存在正相关性(rs=0.323,P=0.012),差异有统计学意义(H=10.811,P=0.029)。新发组的GF均值与治疗组的GF均值差异有统计学意义(Z=-3.116,P=0.002),且新发组的GF均值高于治疗组的GF均值。7例(11.67%)新发病例菌量小于麻风分型对应菌量,均发生于多菌型,其中3例见碎裂菌,3例为Ⅱ型麻风反应。Ⅱ型麻风反应在治疗组中比新发组中多。麻风正规疗程结束后仅68%达到我国卫生部门规定的临床治愈,而未治愈患者均为多菌型。结论：研究发现麻风患者多为青壮年男性,年龄分布与不同年龄段人群的细胞免疫功能及暴露于麻风传染源的机会多少有关。由于麻风临床表现多样性,早期症状不典型,并且部分患者病理上没有麻风特征改变,但不能排除麻风可能,需结合患者临床表现、五点组织液及抗酸染色,争取早诊断、不漏诊和不误诊。麻风患者完成治疗后,仍需长期监测,观察是否达到临床治愈,监测复发情况,及时发现未治愈及复发患者。
[Abstract]:Objective: to investigate the clinical and pathological features of newly developed leprosy patients, to observe the changes of clinical manifestations and pathological changes after treatment, and to evaluate the therapeutic effect. To determine whether to reach clinical cure. Methods: 79 cases of leprosy patients diagnosed and reexamined in our hospital were collected and the clinical data were analyzed retrospectively and the pathological features were observed by HE staining and acid-fast staining after collecting paraffin sections. Statistical analysis was made according to the clinical and pathological data collected. Results: the age of leprosy patients with different leprosy types was not statistically significant, the rate of pathological classification and leprosy classification was 10, and the pathological features of the patients were nonspecific inflammatory changes. There was a positive correlation between the classification of leprosy and the percentage of granuloma (rsl0. 323), and the difference was statistically significant (H0. 811, P0. 029). There was significant difference between the mean value of GF in the new group and that in the treatment group (ZP0. 002), and the mean value of GF in the newly developed group was higher than that in the treatment group (11. 67%), and the bacterial quantity of the new case was lower than that of the corresponding bacteria in leprosy typing. Among them, 3 cases had leprosy type 鈪，

本文编号：2068982