中华皮肤科杂志 ›› 2008, Vol. 41 ›› Issue (11): 736-738.

• 论著 • 上一篇    下一篇

广州地区慢性病毒性肝炎患者甲真菌病流行病学研究

赖维 龚子鉴 黄怀球 郑跃 谢小元 张玉清   

  1. 广州中山大学附属第三医院 中山大学附属第三医院
  • 收稿日期:2007-09-25 修回日期:2007-10-28 发布日期:2008-11-15
  • 通讯作者: 赖维 E-mail:drlaiwei@163.com

Onychomycosis in patients with chronic viral hepatitis: an preliminary survey in Guangzhou city

GONG Zi-Jian   

  • Received:2007-09-25 Revised:2007-10-28 Published:2008-11-15

摘要: 目的 了解广州地区慢性病毒性肝炎(CVH)人群中甲真菌病的患病率、临床分型、菌种构成的现状及其发病与CVH的关系。方法 选取2005年11月至2006年10月在广州地区两家传染病防治机构门诊就诊或住院的CVH患者,对临床拟诊为甲真菌病的患者收集其甲屑做真菌镜检和培养,真菌学检查阳性者确诊为甲真菌病,计算其患病率、临床分型、菌种构成等指标。结果 共收集CVH患者995例,确诊为甲真菌病者116例,甲真菌病总患病率为11.66%,其中轻、中、重、极重度CVH人群的患病率分别为6.20%、8.59%、14.09%、19.67%;CVH病程0.5 ~ 9年、10 ~ 19年、20 ~ 29年、≥30年人群的甲真菌病患病率分别为7.09%、17.29%、19.13%、27.27%。临床分型主要为远端侧位甲下型(69.83%),其次为全甲营养不良型(14.66%)。菌种构成为皮肤癣菌占71.43%、酵母菌占21.43%、霉菌占7.14%,以红色毛癣菌最常见(42.86%)。结论 CVH人群中甲真菌病的患病率与CVH病情的严重程度及病程长短有关,临床分型以远端侧位甲下型多见,病原菌主要是皮肤癣菌,其中以红色毛癣菌最常见。

关键词: 甲癣, 肝炎, 患病率

Abstract: Objective To investigate the incidence, clinical patterns, and species distribution of pathogenic fungi of onychomycosis in patients with chronic viral hepatitis (CVH), and to analyze the relationship between onychomycosis and CVH. Methods From November 2005 to October 2006, direct microscopy and fungal culture were performed on nail samples from CVH patients with clinically suspected onychomycosis in the two largest institutions for communicable disease control in Guangzhou city. The incidence, clinical patterns, and species distribution of pathogenic fungi of onychomycosis were assessed based on the findings in mycologic examinations. Results The study randomly recruited 995 patients with CVH, and onychomycosis was diagnosed in 116 patients. The incidence of onychomycosis was 11.66% in total, 6.20%, 8.59%, 14.09%, 19.67% in patients with mild, moderate, severe and extremely severe CVH respectively, 7.09%, 17.29%, 19.13% and 27.27% in patients with a clinical course of CVH of 0.5-9 years, 10-19 years, 20-29 years, ≥30 years respectively. The most common clinical pattern was distal and lateral subungual onychomycosis (DLSO, 69.83%), followed by total dystrophic onychomycosis (TDO, 14.66%). Among the pathogenic fungi, dermatophytes amounted to 71.43%, yeasts 21.43%, moulds 7.14%, and Trichophyton rubrum was the most frequently isolated fungus (42.86%). Conclusions The incidence of onychomycosis in patients with CVH is correlated with the severity and course of CVH. Among these patients, the most common clinical pattern is DLSO with the most frequent fungal species being dermatophytes and predominant fungal isolate being Trichophyton rubrum.