Abstract：
BACKGROUND: There is a limited number of studies assessing the alterations in nerve function impairment (NFI) in leprosy over an extended period of time. To the best of our knowledge, no published study has evaluated neurological state longitudinally during treatment utilizing a combination of clinical, functional (activity limitation), electrophysiological, and patient-reported quality of life (QOL) outcomes.
METHODS: This prospective, observational study included leprosy patients of all spectra. Over 1 year of treatment, cutaneous and neurological examinations were done in addition to a nerve conduction study (NCS) and sympathetic skin response (SSR) assessment. QOL and activity limitation assessments using the World Health Organization Quality of Life brief version (WHOQOL-BREF) and Screening of Activity Limitation and Safety Awareness scale (SALSA), respectively, were also performed.
RESULTS: Out of 63 leprosy patients, loss of sensation was noted in 43 (68.2%) at baseline. At the completion of treatment, proportionate change revealed no change in 18 (28.5%), restored function in 9 (14.2%), improved status in 34 (53.9%), and deteriorated NFI in only 2 (3.1%) cases. The association between NCS-SSR abnormalities was significant for a longer duration of disease at presentation (P = 0.04), in multibacillary cases [OR 9.12 (95% CI, 1.22-67.93)], in those in reaction [OR 3.56 (95% CI, 0.62-20.36)] and in those aged over 40 [OR 1.93 (95% CI, 0.28-13.41)]. There was an improvement in WHOQOL-BREF and SALSA scores at release from treatment (P = 0.005 and P = 0.01, respectively).
CONCLUSIONS: The majority of leprosy patients on treatment show improvement in NFI at the completion of therapy. However, change is influenced by critical factors such as bacillary load, disease duration, age, and the presence of reaction(s).
METHODS: This prospective, observational study included leprosy patients of all spectra. Over 1 year of treatment, cutaneous and neurological examinations were done in addition to a nerve conduction study (NCS) and sympathetic skin response (SSR) assessment. QOL and activity limitation assessments using the World Health Organization Quality of Life brief version (WHOQOL-BREF) and Screening of Activity Limitation and Safety Awareness scale (SALSA), respectively, were also performed.
RESULTS: Out of 63 leprosy patients, loss of sensation was noted in 43 (68.2%) at baseline. At the completion of treatment, proportionate change revealed no change in 18 (28.5%), restored function in 9 (14.2%), improved status in 34 (53.9%), and deteriorated NFI in only 2 (3.1%) cases. The association between NCS-SSR abnormalities was significant for a longer duration of disease at presentation (P = 0.04), in multibacillary cases [OR 9.12 (95% CI, 1.22-67.93)], in those in reaction [OR 3.56 (95% CI, 0.62-20.36)] and in those aged over 40 [OR 1.93 (95% CI, 0.28-13.41)]. There was an improvement in WHOQOL-BREF and SALSA scores at release from treatment (P = 0.005 and P = 0.01, respectively).
CONCLUSIONS: The majority of leprosy patients on treatment show improvement in NFI at the completion of therapy. However, change is influenced by critical factors such as bacillary load, disease duration, age, and the presence of reaction(s).
摘要：
背景：评估麻风病患者长时间内神经功能损害（NFI）改变的研究数量有限。据我们所知,没有发表的研究使用临床，功能(活动限制)，电生理学,和患者报告的生活质量（QOL）结局。
方法：这种前瞻性，观察性研究包括所有光谱的麻风病人。超过1年的治疗，除了神经传导研究(NCS)和交感神经皮肤反应(SSR)评估外,还进行了皮肤和神经系统检查.使用世界卫生组织生活质量简报版（WHOQOL-BREF）和活动限制筛查和安全意识量表（SALSA）进行生活质量和活动限制评估，分别,也表演了。
结果：在63名麻风病人中，基线时发现43例(68.2%)感觉丧失.治疗完成后,比例变化显示18人(28.5%)无变化，在9个（14.2%）中恢复了功能，34人的状况有所改善(53.9%)，仅2例（3.1％）NFI恶化。NCS-SSR异常之间的关联在出现时的疾病持续时间较长（P=0.04），在多杆菌病例中[OR9.12（95%CI，1.22-67.93）]，反应中的患者[OR3.56（95％CI，0.62-20.36）]和40岁以上的患者[OR1.93（95％CI，0.28-13.41）]。从治疗开始释放时，WHOQOL-BREF和SALSA评分有所改善（分别为P=0.005和P=0.01）。
结论：大多数接受治疗的麻风病患者在治疗结束时表现出NFI改善。然而,变化受细菌负荷等关键因素的影响，疾病持续时间,年龄,和反应的存在。
方法：这种前瞻性，观察性研究包括所有光谱的麻风病人。超过1年的治疗，除了神经传导研究(NCS)和交感神经皮肤反应(SSR)评估外,还进行了皮肤和神经系统检查.使用世界卫生组织生活质量简报版（WHOQOL-BREF）和活动限制筛查和安全意识量表（SALSA）进行生活质量和活动限制评估，分别,也表演了。
结果：在63名麻风病人中，基线时发现43例(68.2%)感觉丧失.治疗完成后,比例变化显示18人(28.5%)无变化，在9个（14.2%）中恢复了功能，34人的状况有所改善(53.9%)，仅2例（3.1％）NFI恶化。NCS-SSR异常之间的关联在出现时的疾病持续时间较长（P=0.04），在多杆菌病例中[OR9.12（95%CI，1.22-67.93）]，反应中的患者[OR3.56（95％CI，0.62-20.36）]和40岁以上的患者[OR1.93（95％CI，0.28-13.41）]。从治疗开始释放时，WHOQOL-BREF和SALSA评分有所改善（分别为P=0.005和P=0.01）。
结论：大多数接受治疗的麻风病患者在治疗结束时表现出NFI改善。然而,变化受细菌负荷等关键因素的影响，疾病持续时间,年龄,和反应的存在。
