Download - 癩病防治宣導手冊 2006製
1
- ( )
L( Leprosy )
1873
( 10 %) 90 %
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:541
2
WHO
1930 195
3429
49
65
88
919194
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:542
3
LEPROSY (Hansen's Disease)
90 %
Mycobacterium Leprae1873 Hansen
Hansen's
11~13
Dr. ArmauerHansen (1841-1912)
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:543
4
2 5 2.5 40
90 %
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:544
5
-destroglycan laminin-2 receptor
( )
Classification
TT BT
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:545
6
TTBT I
1 ( )
23
PGL-1(Epitope)
LAM-B(LL type)
30%
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:546
7
1. (Ziehl-Neelsen Stain )
2. (Kinyoun Stain )Kinyoun's carbolfuchsin
5 Methylene blue(Ziehl-Neelsen Stain carbolfuchsin )
3. (Fite's Stain)xylene/peanut oil 2 10
4. (Auramine-rhodamine fluorochrome stain)auramine-rhodamine mycolic acids
250Ziehl-Neelsen (
(+))
5.PCR( )DNA
DNADNA ( )
6. (Microtiter Particle Agglutination Test)
Colored Polyacrolein Latex Microparticles (PAMP) comjugated 3,6-Di-O-Methyl-D-
Glucose (DMG) (DMG)
7. (Leprosy Test)
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:547
8
8. (Lepromin Skin Test)
1 9 1 8
(T type)
(L type)
(B type )
(I type)
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:548
9
solid
fragmented
granular
MI ( morphological index ) ( )
BI ( bacteriological index ):
/
6+ 00 >1,000 / 1
5+ 100~1000 / 1
4+ 0010~100 / 1
3+ 00001~10 / 1
2+ 00001~10 / 10
1+ 00001~10 / 100 0+ 00000 / 100
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:559
10
BI 2 MB Type( )
BI 1 100 1-10
BI 2 100 10 1-10
BI 3 25 1-10
BI 4 25 10-100
BI 5 25 100-1000
BI 6 25 1000
(Multidrug therapy, MDT)
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5510
11
(Rifampin 300 mg)(Clofazimine 100mg) (Dapsone 100mg)
27(Dapsone 100mg) (Clofazimine 50mg)28
:(1) (2) (3)
30-50 %
(Type I reactions or reversal reactions) (Type IIreactions or ENL, erythema nodosum leprosum) Lucio
type IV6 (
BB BL BT) 1/4
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5511
12
(1)
(2)
(3) 6
type III3
(BL LL BB)50%
(1)
(ENL) (2) (3)
(4)
Luciotype III
(LL)
(1) (2) (3)
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5512
13
I( ): aspirin
chloroquine 2# hs (250 mg/#) ( )
prednisolone 40-60 mg 12 24Clofazimine ( 300mg 100mg)
II( ) prednisolone
60 mgThalidomide: 100 mg 100mg 1. 2.
Clofazimine ( 300mg 100mg)
Thalidomide
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5513
14
:
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5514
15
( )( ) 1.
2.
3.
( ) X ()
( )(Multidrug therapy, MDT)
1.
2. 1
2
3 4
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5515
16
5 P216 P2213.
4.
39
5. 1
B
26.
1
2
1.
2.
(1)a.
(a)
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5516
17
(b)(c)
40(d)
30
(e) b .
(2)
( )( ) 1.
(1)(2)
(3)
(4)
(5) 30
(6)
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5517
18
(7) " "
(8)( 1.5 )
2.
(MDT)
12
12
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5518
19
Q&AQ1A
Q2A
Q3 A
Q4A
Q5 A
Q6A
Q7A
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5519
20
0Q80A
0Q90A
Q10A
Q11A
Q12A
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5520
21
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5521
22
794
08 30~11 3013 30~16 00
•�ƒÀ-02-B.p65 2007/1/29, §U§» 01:5522