浙江某部皮肤真菌病流行病学调查及药敏试验

高温、潮湿多雨、湿度大是浙江省地处东南沿海地区主要的气候特征。皮肤真菌病发病率较高。而部队由于条件艰苦,缺乏有效的治疗药物,许多官兵的皮肤真菌病得不到有效的治疗,对他们的健康和部队的战斗力有一定的影响。为了摸清该地区部队官兵皮肤真菌病的发病情况和致病菌种,筛选出有效、适宜的治疗药物,2002年7月我们对驻浙江某部队进行相关流行病学调查。     

某院校学员浅部真菌病调查分析CSCD

目的了解华北某部队院校学员浅部真菌性皮肤病患病及诊治情况。方法采取浅部真菌病体检筛查、真菌镜检和问卷调查方式。结果回收1733份有效问卷,结果显示:①学员入校后确诊患浅部真菌性皮肤病186例,发病率为10.73%,足癣(147例)发病率最高,总体发病率低于南方地区。②夏、秋季浅部真菌性皮肤病的发病率显著高于冬、春季。③不同服役年限的浅部真菌性皮肤病发病率差异有统计学意义。④70.87%患者使用外用药物治疗,6.80%患者使用外用和口服药物联用,咪唑类药物使用率最高。患者对抗真菌药物的治疗效果满意度50.62%,复发率为51.46%。结论院校学员浅部真菌病发病率较高,加强健康宣教、合理用药指导意义重大。     

上海新泾社区50岁以上居民足癣患病情况调查

皮肤癣菌病是临床常见皮肤病,包括体癣、股癣、头癣、甲癣及手足癣等,其中足癣发病率最高.足癣在全世界广为流行,在热带和亚热带地区更为普遍.在我国,足癣的发病率甚高,据1975年上海市对11万人普查,足癣的发病率为36.76％.在一些职业和集体中,甚至可高达80％～100％.随着经济发展及人们生活水平的提高,足癣引起人们越来越多的重视,关于足癣在运动员、军人、矿工及青少年人群中的调查研究已有不少[1-4].     

正常人甲真菌病与糖尿病患者甲真菌病的比较

甲真菌病是皮肤真菌病的常见病.外伤、足癣和糖尿病等是其常见的诱发因素.为研究糖尿病合并甲真菌病患者发病特点,本文对临床单纯甲真菌病患者及糖尿病合并甲真菌病患者甲真菌病的临床类型、严重程度和菌种分布进行了比较.现报告如下.     

47766例拟诊皮肤真菌病患者病原菌分离培养结果分析

目的了解本院门诊拟诊皮肤真菌病患者真菌感染状况,掌握近期本地区皮肤真菌感染菌种分布结构。方法采用KOH直接涂片或染色显微镜观察与分离培养相结合的方法,对分离的菌落进行形态学鉴定,对真菌镜检和培养鉴定结果进行统计分析。结果 47 766例拟诊皮肤真菌病患者中,直接镜检和(或)培养阳性25 078例,占52.50%。其中皮肤癣菌病9 310例(48.94%)、马拉色菌感染8 938例(46.99%)、念珠菌及其他酵母菌感染603例(3.17%)。除外马拉色菌镜检和(或)培养阳性,其余38 839例镜检阳性率40.33%、分离培养阳性率25.99%。分离培养与镜检阳性符合率61.41%。皮肤癣菌菌种结构方面,红色毛癣菌为优势菌种占88.19%。结论皮肤癣菌病位居皮肤真菌病之首,以红色毛癣菌为优势菌,念珠菌及其他酵母菌感染亦值得关注。     

萘替芬酮康唑乳膏治疗皮肤真菌病安全性与有效性的meta分析

目的综合评价萘替芬酮康唑乳膏治疗皮肤真菌病的有效性及安全性。方法在The Cochrane Library、Medline、Embase、CBM、中国知网(CNKI)、维普和万方数据库上检索萘替芬酮康唑乳膏与其他抗真菌药物单药治疗皮肤真菌病的随机对照研究,用NoteExpress进行文献筛选及资料提取,使用RevMan5.3进行系统评价。结果最终纳入43篇文献,共5413名患者,治疗有效率为85.27%。分析结果显示萘替芬酮康唑乳膏疗效优于硝酸咪康唑[RR=1.32,95%CI (1.26,1.38)],优于联苯苄唑治疗4周组[RR=1.31,95%CI (1.12,1.54)],优于酮康唑[RR=1.25,95%CI (1.14,1.36)]。萘替芬酮康唑在复发率及不良反应发生率上低于其他药物。结论萘替芬酮康唑乳膏可有效治疗皮肤真菌病,且更加安全。     

全球近10年无绿藻病例报道文献的回顾

该文系统性地回顾分析了人类无绿藻病在近10a来的发病率及其趋势,并对该病的流行病学、临床表现、诊断标准、治疗方案及其预后的新特点进行了总结。全球至今已报道190例无绿藻病,约33%的无绿藻病例在近10a内发生;系统性无绿藻发病率在近10a病例数与皮肤型无绿藻病基本持平。我国大陆地区总共报道有9例无绿藻病,大约占我国(包括港澳台地区)已有报道的无绿藻病例总数的50%。无绿藻病的诊断主要依靠标本的真菌学及组织病理学检查。两性霉素B及其脂质体仍然是该病治疗最常用且最有效的药物。提示无绿藻病在近10a中发病率明显上升,且系统性无绿藻发病率显著升高。     

网络化管理对降低秦皇岛地区出生人口缺陷率的价值分析

目的:探讨网络化管理对降低秦皇岛地区出生人口缺陷率的应用价值。方法:选取2011年-2016年秦皇岛地区214404例新生儿两病(苯丙酮尿症和先天性甲状腺功能低下症)筛查的统计资料,并统计2011年至2016年每年及6年的筛查率和两病的筛查发病率,并与秦皇岛地区前6年两病的发生率进行对比。结果:秦皇岛地区6年内总筛查率为98.0010%,确诊苯丙酮尿症27例,先天性甲状腺功能低下症79例,两病的筛查疾病发病率分别为1/7782和1/2660。与前6年相比,2011至2016年两病的发生率均明显下降(P0.05)。结论:网络化管理通过及时预知并召回可疑患儿,对其采取行预防措施或者一定的治疗手段,降低了秦皇岛地区出生人口缺陷率,同时使新生儿筛查真实、完整、准确,效率较高,较易查询。     

《中国真菌病学杂志》“诺华(中国)非处方药”“中国好医生”之兰美抒~临床应用有奖征文

盐酸特比萘芬是强效抗真菌药物,具有强效杀真菌、减少复发,缩短疗程,抗炎、亲脂等特点。其原研产品兰美抒(Lamisil)由诺华公司于1979年研制成功,在国外兰美抒被广泛应用于治疗各种浅部真菌病,是全球治疗皮肤真菌病第一品牌。在我国,该产品的10g新包装乳膏制剂于2011年由诺华(中国)非处方药重新上市,自上市以来,已在全国许多地区得到了广泛临床应用和认可。     

刺槐上分离的花生矮化病毒的研究

刺槐花叶病是我国北方刺槐（Ｒｏｂｉｎｉａｐｓｅｕｄｏａｃａｃｉａ）常见病害。１９８７～１９９５年对河南、河北、山东和北京部分地区刺槐进行调查,刺槐花叶病发病率为４％～８７．５％。该病害主要特征是：叶片出现浅绿与绿色相间带有疱疹的花叶症状,叶缘波状扭...     

A study of 3891 cases of mycoses in the tropics.

4103 cases suspected of mycoses were analysed as to sex, age and site of disease and 3891 were proved cases. This group formed 50% of total mycoses or 13-93% of all dermatoses recorded in the Government General Hospital, Madras, during the period of study. There were 66-26% adult female, 27-6% adult male and 6-14% were below 13 years. Dermatophytoses were found in 73-5%; the other common diseases were tinea versicolor (17-68%) and candidiasis (12-43%). Multiple sites of involvement or more than 1 disease in the same individual were mostly observed. The incidence of piedra (0-1%) and deep mycoses (0-156%) was very low. Mycetoma was the common disease (5/6) in deep mycoses. In dermatophytoses, tinea corporis (49-71%) and tinea cruris (47-85%) commonest; tinea axillaris (3-42%), tinea capitis (1-72%) and tinea barbae (1-29%) were less common. The incidence of tinea manuum, tinea pedis and tinea unguium was similar (4-97%-6-38%). High temperature and humidity were related to the higher incidence of tinea corporis, tinea cruris and tinea versicolor. Mainly children suffered from tinea capitis. All other mycoses were commonly found in adults between 2nd and 3rd decades. In all mycoses but candidiasis, female predominated. Cutaneous candidiasis was mainly a problem of housewives. Among the dermatophytes Trichophyton violaceum was predominant (33-7%) followed by T. rubrum (32-6%). Trichophyton schoenleinii and M. gypseum were rarely isolated. From mycetoma, Madurella mycetomii, Nocardia braziliensis, N. asteroides and Actinomadura spp. were isolated. Demonstration of Cryptococcus laurentii in 1 case is reported in this area for the first time.     

Griseofulvin in the treatment of dermatomycoses and onychomycoses produced by dermatophytes of the Trichophyton group

Summary Based on observations on the therapy of 128 patients affected with tinea unguium, tinea manus et pedis, tinea granulomatosa nodularis (Granuloma Majocchi), tinea cruris, tinea corporis, tinea barbae and tinea capitis due to infection with dermatophytes of theTrichophyton group, determinations were made for the absolute and relative indication of griseofulvin in the treatment of these mycoses. For each affection, comparisons were made between the therapeutic results obtained by combined therapy with oral griseofulvin (uniform daily dose 1 g for each case) and local therapy with 1 % water solution organic dyes, coal tar on the one hand, and mere local therapy as described above, on the other. For treatment, griseofulvin of different production was available: British Grisovin, Likuden and Likuden M from West-Germany, and Griseofulvin produced in the German Democratic Republic. No essential differences were found in the therapeutic effect of the individual preparations, the tolerance, however, was found to be best with Likuden. On the basis of comparisons made for the results of the individual methods of treatment, griseofulvin therapy was found to be an absolute indication of the mycotic diseases as follows: tinea capitis, tinea cruris follicularis trichophytica and tinea unguium. A relative indication was found to be tinea corporis, tinea barbae, tinea cruris, and tinea manus et pedis.All patients were subjected to microscopic and culture examination. The frequency of the individual dermatophytes was as follows:Trichophyton rubrum in 56 cases,Trichophyton verrucosum in 19 cases,Trichophyton mentagrophytes in 16 cases, andTrichophyton violaceum in 1 case. Thirty six cases showed negative cultures.In conclusion, the author recommends individual selection of patients for the griseofulvin therapy.     

无锡地区293例儿童浅部真菌病临床分析

目的研究无锡地区儿童浅部真菌病的流行及病原菌特点。方法采用真菌镜检和含氯霉素(和含氯霉素及放线菌酮)的葡萄糖蛋白胨琼脂培养,根据菌落形态及其镜下形态鉴定菌种。结果 293例临床诊断患儿中,直接镜检阳性245例,阳性率83.6%,其中皮肤念珠菌病、足癣、头癣发病例数居前3位,分别为79例(32.2%)、50例(20.4%)和46例(18.8%),共175例,占总病例数的71.4%,其次分别为体癣、甲真菌病、手癣、股癣、花斑糠疹,分别为29例(11.8%)、13例(5.3%)、11例(4.5%)、10例(4.1%)、7例(2.9%)。随着年龄增长,患儿易患疾病有所差异,花斑糠疹0～2岁发病率最高;皮肤念珠菌病0～3岁发病率最高;头癣4～8岁发病率最高;体股癣、手、足癣9～15岁发病率最高。238例镜检阳性标本(7例花斑糠疹除外)共培养出致病菌145株,阳性率为60.9%,其中皮肤念珠菌病培养阳性率为70.9%,股癣70%,体癣51.7%,甲真菌病53.8%,头癣65.2%,足癣50%,手癣45.5%。在145株致病菌中,念珠菌属63例(43.45%),红色毛癣菌43例(29.7%),犬小孢子菌26例(17.93%),须癣毛癣菌4例(2.76%),紫色毛癣菌3例(2.07%),石膏样小孢子菌3例(2.07%),断发毛癣菌2例(1.38%),絮状表皮癣菌1例(0.69%)。结论本研究为无锡地区防治儿童浅部真菌病提供了依据。     

822例浅部真菌病及其致病菌种分析

目的分析新疆乌鲁木齐市浅部真菌病病原菌的流行趋势。方法对2006年1月～2013年12月就诊于我院皮肤科门诊、有典型临床表现、真菌镜检及培养均阳性的822例患者进行致病病种及菌种分析。使用SPSS17．0统计软件对于结果进行统计分析。结果822例患者包括8个病种：体癣214例（26．0％）,足癣131例（15．9％）,头癣128例（15．6％）,甲真菌病125例（15．2％）,股癣119例（14．5％）,手癣54例（6．6％）,皮肤念珠菌病38例（4．6％）,花斑糠疹13例（1．6％）。菌种分布以须癣毛癣菌为首位,336株（40．9％）,其次为红色毛癣菌共239株（29．1％）,犬小孢子菌68株（8．3％）,铁锈色小孢子菌48株（5．8％）,念珠菌38株（4．6％）,断发毛癣菌33株（4．0％）,许兰黄癣菌23株（2．8％）,马拉色菌13株（1．6％）,疣状毛癣菌9株（1．1％）,紫色毛癣菌7株（0．9％）,支顶孢霉菌4株（0．5％）,曲霉、絮状表皮癣菌各2株（各0．2％）。统计学分析显示：不同性别足癣、股癣、甲真菌病及花斑糠疹构成比有统计学意义（P〈0．05）,除体癣及花斑糠疹外,本组其他浅部真菌病的分布在年龄方面有着明显的差别（P〈O．05）。结论乌鲁木齐市浅部真菌病发病率排在前3位的依次为体癣、足癣、头癣,致病病原菌以毛癣菌为主,须癣毛癣菌为首位致病菌,其次为红色毛癣菌。足癣及甲真菌病好发于女性,而股癣及花斑糠疹好发于男性。除体癣及花斑糠疹外,不同年龄段浅部真菌病分布有明显差异,其中头癣主要好发于青少年。     

Dermatophytes isolated in Hospital Universitario 12 de Octubre (Madrid, Spain).

Over a 10 year period (January 1988 - December 1997), 3,241 dermatophyte strains were isolated from 18,465 specimens from patients in whom dermatophytosis was suspected clinically. This represents a 17.5% rate of isolation. Trichophyton rubrum (38.44%), Microsporum canis (28.75%), Epidermophyton floccosum (14.5%) and Trichophyton mentagrophytes (13.5%) were the dominant species, and Trichophyton tonsurans (2.09%) has emerged, whilst in the previous decade it had virtually disappeared. Our study is basically based on an out-patient selected population, and tinea corporis (30.79%), followed by tinea cruris (16.69%) and tinea unguium (16.69%) were the most prevalent clinical forms.     

Epidemiologic study of dermatophytoses in Salamanca (Spain)

An epidemiologic study of the dermatophytoses in Salamanca (Spain) from 1973 to 1976 was performed. Dermatophyte species were identified in 224 patients with clinical tinea infections; 31 bovines, 18 rodents and 70 soil samples. The prevalence of Trichophyton verrucosum and Epidermophyton floccosum was strikingly high in relation to other statistics. The most common clinical forms were tinea corporis and tinea cruris. Tinea capitis by anthropophilic species was uncommon.     

1株致体股癣的颗粒型红色毛癣菌变种的形态学观察与基因鉴定

目的：探讨1株致体股癣的颗粒型红色毛癣菌变种的形态学特点及核糖体基因序列变化。方法1例体股癣患者皮损中分离出1株红色毛癣菌,观察形态学特点,并用PCR测定核糖体转录间区（ITS）、D1/D2区、非转录区基因序列（NTS区）内串联重复亚单位（TRS）。结果该菌株可产生鹿角形菌丝,大分生孢子有中空现象及单侧出芽产孢特征,可在42℃生长;ITS和D1/D2区基因测序鉴定为红色毛癣菌,但TRS-1和TRS-2基因序列分别有2个、1个碱基差异。结论该菌株可能是颗粒型红色毛癣菌的1个变种。     

A study of dermatophytosis in South West of Iran (Ahwaz)

Two hundred and seventy nine patients suspected of having fungal lesions were examined. Skin scrapping, hair samples and nail clippings were collected from patients. Direct and culture examinations were performed for all samples. About 115 cases of examined subjects had dermatophytosis. Dermatophytosis occurred mainly in adults males (20–29 years). Tinea cruris (24.3%) was the most common type of dermatophytosis followed by tinea pedis (16.5%), tinea corporis (14.8%), tinea ungium (13%), tinea capitis (11.3%), tinea faciei (11.3%), tinea manuum (7%) and tinea barbae (1.7%). Trichophyton mentagrophytes was the most prevalent species followed by Epidermophyton floccosum.     

Prevalence of Dermatophytoses in the Zarqa District of Jordan

A total of 350 clinically suspected cases of dermatomycoses were examined for causative fungi during July 1997 to September 1998. Mycotic infection was demonstrable by microscopy and culture in 199 (56.8%) cases. The most common superficial mycotic infections were tinea pedis (35.2%) followed by tinea capitis (23.1%), tinea unguium (21.6%) and tinea corporis (10.6%). Most of the infected patients were 1–9, 20–29 and 30–39 years old. Men were mainly infected with tinea cruris and tinea pedis, while women were infected with tinea pedis, tinea unguium and tinea capitis. The frequencies of etiological agents isolated from patients were as follows: Trichophyton mentagrophytes var. interdigitale (32.7%), T. rubrum (28.6%), Epidermophyton floccosum (20.1%), Microsporum canis (11.1%), T.schoenleinii (4%), T.verrucosum (2%), T.violaceum (1%), and M. gypseum (0.5%). The number of infections varied with the seasons. The highest number of cases of tinea pedis and tinea cruris occurred in the summer months, while tinea capitis, tinea corporis and tinea unguium occurred in the spring and winter months. This revised version was published online in June 2006 with corrections to the Cover Date.     

2%硝酸舍他康唑乳膏治疗体股癣和足癣疗效和安全性评价

目的 评价2％硝酸舍他康唑乳膏治疗足癣和体、股癣的疗效及安全性,并与2％硝酸咪康唑乳膏对照。方法 采用多中心随机双盲对照试验。试验组及对照组分别外用2％硝酸舍他康唑乳膏和2％硝酸咪康唑乳膏,每天2次,疗程4周。在治疗开始及治疗2周、4周、6周时进行观察。结果 足癣试验组61例,对照组58例;体、股癣试验组56例,对照组55例完成了观察。足癣在4周时,临床有效率试验组98．36％,对照组93．10％,在6周时分别为100％和98．28％;在4周和6周时真菌学清除率试验组均为95．1％,对照组均为100％;在4周时总有效率试验组98．36％,对照组93．10％,在6周时分别为100％和98．28％。体、股癣在4周时,临床有效率试验组98．21％,对照组92．73％,在6周时分别为100％和98．18％;在4周和6周时真菌学清除率试验组和对照组均为100％;在4周时总有效率试验组98．21％,对照组92．73％,在6周时分别为100％和98．18％。药物不良反应发生率试验组1．7％,对照组0．9％,表现为局部刺激。结果 显示2％硝酸舍他康唑乳膏治疗足癣和体、股癣的疗效及安全性与2％硝酸咪康唑乳膏相似（P〉0．05）。结论 2％硝酸舍他康唑乳膏治疗足癣和体、股癣有效、安全。