云南省新發(fā)及治療麻風(fēng)病例的臨床與病理關(guān)系
發(fā)布時(shí)間:2018-06-26 03:59
本文選題:麻風(fēng) + 組織病理; 參考:《昆明醫(yī)科大學(xué)》2015年碩士論文
【摘要】:目的:探討新發(fā)麻風(fēng)病例臨床表現(xiàn)及病理特點(diǎn);對(duì)麻風(fēng)治療患者(治療療程已足)進(jìn)行監(jiān)測,觀察臨床表現(xiàn)變化及治療后病理改變特點(diǎn),評(píng)估治療效果,判斷是否到達(dá)臨床治愈。方法:收集于我院診斷及復(fù)查的麻風(fēng)病人79例,回顧性分析臨床資料;對(duì)收集組織蠟塊切片后做HE染色和抗酸染色,觀察病理特點(diǎn)。根據(jù)收集的臨床和病理資料進(jìn)行統(tǒng)計(jì)分析。結(jié)果:在新發(fā)病例中麻風(fēng)患者不同麻風(fēng)分型、菌量對(duì)應(yīng)的年齡無統(tǒng)計(jì)學(xué)意義;病理分型與麻風(fēng)分型不一致率為10%,不一致的患者病理表現(xiàn)為非特異性炎癥改變。麻風(fēng)分型與GF(肉芽腫分?jǐn)?shù))存在正相關(guān)性(rs=0.323,P=0.012),差異有統(tǒng)計(jì)學(xué)意義(H=10.811,P=0.029)。新發(fā)組的GF均值與治療組的GF均值差異有統(tǒng)計(jì)學(xué)意義(Z=-3.116,P=0.002),且新發(fā)組的GF均值高于治療組的GF均值。7例(11.67%)新發(fā)病例菌量小于麻風(fēng)分型對(duì)應(yīng)菌量,均發(fā)生于多菌型,其中3例見碎裂菌,3例為Ⅱ型麻風(fēng)反應(yīng)。Ⅱ型麻風(fēng)反應(yīng)在治療組中比新發(fā)組中多。麻風(fēng)正規(guī)療程結(jié)束后僅68%達(dá)到我國衛(wèi)生部門規(guī)定的臨床治愈,而未治愈患者均為多菌型。結(jié)論:研究發(fā)現(xiàn)麻風(fēng)患者多為青壯年男性,年齡分布與不同年齡段人群的細(xì)胞免疫功能及暴露于麻風(fēng)傳染源的機(jī)會(huì)多少有關(guān)。由于麻風(fēng)臨床表現(xiàn)多樣性,早期癥狀不典型,并且部分患者病理上沒有麻風(fēng)特征改變,但不能排除麻風(fēng)可能,需結(jié)合患者臨床表現(xiàn)、五點(diǎn)組織液及抗酸染色,爭取早診斷、不漏診和不誤診。麻風(fēng)患者完成治療后,仍需長期監(jiān)測,觀察是否達(dá)到臨床治愈,監(jiān)測復(fù)發(fā)情況,及時(shí)發(fā)現(xiàn)未治愈及復(fù)發(fā)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,
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