化学療法によるらい菌指数の消長

らい化学療法協同研究班

doi:10.5025/hansen1977.46.147

化学療法によるらい菌指数の消長

らい化学療法協同研究班

著者情報

ジャーナルフリー

1977 年 46 巻 4 号 p. 147-158

DOI https://doi.org/10.5025/hansen1977.46.147

詳細

発行日: 1977/12/30 受付日: 1977/03/31 J-STAGE公開日: 2008/02/26 受理日: - 早期公開日: - 改訂日: -
訂正情報
訂正日: 2008/02/26 訂正理由: - 訂正箇所: 論文抄録訂正内容: Wrong : Almost thirty years went by since the chemotherapy of leprosy had been introduced in Japan. At present, it is one of the most important problems for us how control the cases of the so-called persistently bacillary positive cases which are found in lepromatous leprosy.
At the first step to dissolving this problem, we tried, from clinical side, to make clear the standard bacillary clearance time (BCT, Takizawa)6) of the patients which were treated in the past. We had organized a co-operative research team among leprosaria and two medical faculties of universities in Japan to collect the results of the past chemotherapy of leprosy.
We made a preliminary investigation on the new cases of which treatments were started from 1957 to 1963. The number of the cases is listed in Table 1. Among these cases, the main detailed investigation was performed on 367 cases, and finally on 263 cases of lepromatous and borderline cases in which past bacillary indices were well arranged. For lepromatous cases, we divided three grades according to the extent of the eruptions, those are L1 L2 and L3, as shown in Fig. 1. In the main investigation, we collected the records on transition of bacillary indices, kind of the drugs, their doses regularities, grades of ENL and som factors which we shall referred later.
Practically, the descending line of bacillary indices (B. I.) in the course of chemotherapy takes the polygonal line which is shown in Fig. 2. This might depend on variety of the technic and portions of taking smear. We adopted the highest values of B. I. through a year and showed them with Ridley's B. I. scale. As an indicator of judging negativation of the bacilli, we adopted the first point of becoming negative and remained so at least more than one year, following Takizawa's adovocation as bacterial clearance time (BCT)6).
We calculated BCT of each group, divided according to the types and grades of the disease and kinds of drugs which were administered, as shown in Table 2.
The ranges and the mean values of each group are diagrammed in Fig. 3.
As we can see in Table 2 and Fig. 3, the number of L3 (diffuse or papulo-nodular) treated with Promin and DDS was most numerous. Therefore, taking this value as a standard, we compared it with others. The results of this comparison are also shown in Table 2.
We calculated the estimated equation with Rao's method7) for each group and diagrammed in Fig. 4. From this calculation, we take the BCT value of L3 (diffuse or papulo-nodular), namely 6.91 (about seven years) as the standard BCT and we constructed the longest limit of BCT in the ususal lepromatous cases by chemotherapy as 6.91+1.92×2=10.85 years.
Then we made multiple regression analysis for estimating BCT from some values of B. I.. But the result was not always satisfactory for practical use as shown in Table 3.
Finally we studied to find correlation BCT and some factors which might give some influence upon BCT. No correlation or significant difference was found between BCT and time of appearing eruptions before the start of the treatment, lepromin test at the start of the treatment, presence of the same disease in the family, and age of the patients at the start of the treatment, respectively. However, as shown in Table 4, occurence of ENL prolonged BCT significantly. The comparison of BCT between male and female also revealed significant longer BCT in female than in male, contrary to our expectation. In fact, the female cases in our observation had a tendency to comlicate ENL more frequently, compared with male cases. But we could not make it clear statistically by the lack of materials. Further observation shall be expected.
Right : Almost thirty years went by since the chemotherapy of leprosy had been introduced in Japan. At present, it is one of the most important problems for us how control the cases of the so-called persistently bacillary positive cases which are found in lepromatous leprosy.
At the first step to dissolving this problem, we tried, from clinical side, to make clear the standard bacillary clearance time (BCT, Takizawa)⁶⁾ of the patients which were treated in the past. We had organized a co-operative research team among leprosaria and two medical faculties of universities in Japan to collect the results of the past chemotherapy of leprosy.
We made a preliminary investigation on the new cases of which treatments were started from 1957 to 1963. The number of the cases is listed in Table 1. Among these cases, the main detailed investigation was performed on 367 cases, and finally on 263 cases of lepromatous and borderline cases in which past bacillary indices were well arranged. For lepromatous cases, we divided three grades according to the extent of the eruptions, those are L1 L2 and L3, as shown in Fig. 1. In the main investigation, we collected the records on transition of bacillary indices, kind of the drugs, their doses regularities, grades of ENL and som factors which we shall referred later.
Practically, the descending line of bacillary indices (B. I.) in the course of chemotherapy takes the polygonal line which is shown in Fig. 2. This might depend on variety of the technic and portions of taking smear. We adopted the highest values of B. I. through a year and showed them with Ridley's B. I. scale. As an indicator of judging negativation of the bacilli, we adopted the first point of becoming negative and remained so at least more than one year, following Takizawa's adovocation as bacterial clearance time (BCT)⁶⁾.
We calculated BCT of each group, divided according to the types and grades of the disease and kinds of drugs which were administered, as shown in Table 2.
The ranges and the mean values of each group are diagrammed in Fig. 3.
As we can see in Table 2 and Fig. 3, the number of L3 (diffuse or papulo-nodular) treated with Promin and DDS was most numerous. Therefore, taking this value as a standard, we compared it with others. The results of this comparison are also shown in Table 2.
We calculated the estimated equation with Rao's method⁷⁾ for each group and diagrammed in Fig. 4. From this calculation, we take the BCT value of L3 (diffuse or papulo-nodular), namely 6.91 (about seven years) as the standard BCT and we constructed the longest limit of BCT in the ususal lepromatous cases by chemotherapy as 6.91+1.92×2=10.85 years.
Then we made multiple regression analysis for estimating BCT from some values of B. I.. But the result was not always satisfactory for practical use as shown in Table 3.
Finally we studied to find correlation BCT and some factors which might give some influence upon BCT. No correlation or significant difference was found between BCT and time of appearing eruptions before the start of the treatment, lepromin test at the start of the treatment, presence of the same disease in the family, and age of the patients at the start of the treatment, respectively. However, as shown in Table 4, occurence of ENL prolonged BCT significantly. The comparison of BCT between male and female also revealed significant longer BCT in female than in male, contrary to our expectation. In fact, the female cases in our observation had a tendency to comlicate ENL more frequently, compared with male cases. But we could not make it clear statistically by the lack of materials. Further observation shall be expected.

訂正日: 2008/02/26 訂正理由: - 訂正箇所: 著者情報訂正内容: 訂正前 : 新井正男¹⁾⁵⁾, 荒川巌¹⁾²⁾, 横田篤三¹⁾³⁾, 小林茂信¹⁾⁴⁾, 硲省吾¹⁾⁵⁾, 左奈田精孝¹⁾⁵⁾, 小関正倫¹⁾⁵⁾, 石原重徳¹⁾⁶⁾, 原田禹雄¹⁾⁷⁾, 尾崎元昭¹⁾⁷⁾, 平野英之助¹⁾⁸⁾, 松本淑子¹⁾⁹⁾, 熊丸茂¹⁾¹⁰⁾, 春日俊章¹⁾¹⁰⁾, 徳田博重¹⁾¹¹⁾, 有薗秀夫¹⁾¹²⁾, 犀川一夫¹⁾¹³⁾, 馬場省二¹⁾¹⁴⁾, 湯川智¹⁾¹⁵⁾, 滝沢英夫¹⁾¹⁶⁾, 伊藤利根太郎¹⁾¹⁷⁾, 森竜男¹⁾¹⁷⁾, 福富和夫¹⁾¹⁸⁾
訂正後 : らい化学療法協同研究班

訂正日: 2008/02/26 訂正理由: - 訂正箇所: 所属機関情報訂正内容: 訂正前 :
1) らい化学療法協同研究班
2) 松丘保養園
3) 東北新生園
4) 栗生楽泉園
5) 多磨全生園
6) 駿河療養所
7) 長島愛生園
8) 邑久光明園
9) 大島青松園
10) 菊池恵楓園
11) 星塚敬愛園
12) 奄美和光園
13) 沖縄愛楽園
14) 宮古南静園
15) 神山復生病院
16) 京都大学医学部皮膚病特別研究施設
17) 大阪大学微生物病研究所
18) 国立公衆衛生院

訂正日: 2008/02/26 訂正理由: - 訂正箇所: PDFファイル訂正内容: -

抄録

Almost thirty years went by since the chemotherapy of leprosy had been introduced in Japan. At present, it is one of the most important problems for us how control the cases of the so-called persistently bacillary positive cases which are found in lepromatous leprosy.
At the first step to dissolving this problem, we tried, from clinical side, to make clear the standard bacillary clearance time (BCT, Takizawa)⁶⁾ of the patients which were treated in the past. We had organized a co-operative research team among leprosaria and two medical faculties of universities in Japan to collect the results of the past chemotherapy of leprosy.
We made a preliminary investigation on the new cases of which treatments were started from 1957 to 1963. The number of the cases is listed in Table 1. Among these cases, the main detailed investigation was performed on 367 cases, and finally on 263 cases of lepromatous and borderline cases in which past bacillary indices were well arranged. For lepromatous cases, we divided three grades according to the extent of the eruptions, those are L1 L2 and L3, as shown in Fig. 1. In the main investigation, we collected the records on transition of bacillary indices, kind of the drugs, their doses regularities, grades of ENL and som factors which we shall referred later.
Practically, the descending line of bacillary indices (B. I.) in the course of chemotherapy takes the polygonal line which is shown in Fig. 2. This might depend on variety of the technic and portions of taking smear. We adopted the highest values of B. I. through a year and showed them with Ridley's B. I. scale. As an indicator of judging negativation of the bacilli, we adopted the first point of becoming negative and remained so at least more than one year, following Takizawa's adovocation as bacterial clearance time (BCT)⁶⁾.
We calculated BCT of each group, divided according to the types and grades of the disease and kinds of drugs which were administered, as shown in Table 2.
The ranges and the mean values of each group are diagrammed in Fig. 3.
As we can see in Table 2 and Fig. 3, the number of L3 (diffuse or papulo-nodular) treated with Promin and DDS was most numerous. Therefore, taking this value as a standard, we compared it with others. The results of this comparison are also shown in Table 2.
We calculated the estimated equation with Rao's method⁷⁾ for each group and diagrammed in Fig. 4. From this calculation, we take the BCT value of L3 (diffuse or papulo-nodular), namely 6.91 (about seven years) as the standard BCT and we constructed the longest limit of BCT in the ususal lepromatous cases by chemotherapy as 6.91+1.92×2=10.85 years.
Then we made multiple regression analysis for estimating BCT from some values of B. I.. But the result was not always satisfactory for practical use as shown in Table 3.
Finally we studied to find correlation BCT and some factors which might give some influence upon BCT. No correlation or significant difference was found between BCT and time of appearing eruptions before the start of the treatment, lepromin test at the start of the treatment, presence of the same disease in the family, and age of the patients at the start of the treatment, respectively. However, as shown in Table 4, occurence of ENL prolonged BCT significantly. The comparison of BCT between male and female also revealed significant longer BCT in female than in male, contrary to our expectation. In fact, the female cases in our observation had a tendency to comlicate ENL more frequently, compared with male cases. But we could not make it clear statistically by the lack of materials. Further observation shall be expected.

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