大学生蠕形螨感染危险因素logistic回归分析

目的:探讨大学生蠕形螨感染的危险因素,为大学生蠕形螨感染的防治提供依据.方法:采用透明胶纸粘贴法和调查问卷,对2004年洛阳市高校1～4年级大学生蠕形螨感染的影响因素进行多因素logistic回归分析.结果:338名大学生蠕形螨阳性者84名,感染率为24.85%.多因素回归分析显示,面部皮肤损害、家庭年人均收入、洗浴用具单用习惯、皂类洗脸习惯和学习专业类型为影响大学生蠕形螨感染的主要因素.结论:大学生蠕形螨感染与皮肤状况、社会、行为因素关系密切,其中行为因素在大学生蠕形螨感染中的作用不容忽视.     

茶树油眼贴联合睑缘深度清洁治疗蠕形螨睑缘炎的临床疗效

目的：观察茶树油眼贴联合睑缘深度清洁对蠕形螨睑缘炎的临床治疗效果。

方法：前瞻性随机双眼对照临床研究。收集2018-11/2019-05就诊西安市人民医院(西安市第四医院)干眼门诊的蠕形螨睑缘炎患者32例64眼,男14例,女18例,年龄12～65(平均37±14)岁。采用随机法将受试者的一只眼纳入研究组,另一只眼纳入对照组。研究组采用茶树油眼贴治疗(1次/d)联合睑缘深度清洁(1次/mo),对照组仅使用茶树油眼贴治疗。记录两组治疗前、治疗3mo后受试者的主观症状、蠕形螨计数、睑缘清洁程度、睑缘异常、首次非侵入式泪膜破裂时间(NITBUT-first)、泪河高度(TMH)、眼红指数(Redness)、睑板腺红外线照相检查、泪液分泌试验(SⅠt)、角膜染色(FL)结果。

结果：治疗3mo后,两组蠕形螨计数均较治疗前明显下降,研究组蠕形螨计数低于对照组(均P<0.05); 两组睑缘清洁程度均得到明显改善,且研究组评分低于对照组(均P<0.05); 两组受试者主观症状评分明显改善(均P<0.05)。治疗3mo后,研究组NITBUT-first、眼红指数、FL均得到明显改善(均P<0.05),对照组眼红指数、FL得到明显改善(均P<0.05),NITBUT-first中位数较治疗前有所增加,但差异无统计学意义; 两组间眼表泪液指标的改善程度、TMH、SⅠt均无明显变化。睑板腺缺失程度评分(MGS)在治疗前后及两组间均无明显差异。受试者治疗过程中未出现接触性皮炎、过敏反应、角结膜损伤等相关并发症。

结论：茶树油眼贴贴敷双眼,可明显降低睫毛毛囊蠕形螨数量、减少鳞屑,改善患者症状、增加泪膜稳定性、减轻眼表炎症; 睑缘深度清洁可进一步清除睑缘袖套状鳞屑,维持睑缘清洁程度,改善睑缘异常,从而加强茶树油眼贴的除螨效果。茶树油眼贴联合睑缘深度清洁治疗蠕形螨睑缘炎,是一种简便易行、安全有效的治疗方式。     

改良Coston法提高蠕形螨性睑缘炎诊断效能的初步研究

目的 分析改良Coston法的诊断效能及可重复性,并比较改良前、后睑缘蠕形螨检出特征。设计 诊断技术评价。研究对象 2018年北京同仁医院临床拟诊为蠕形螨性睑缘炎患者131例。方法 传统及改良Coston法均自患者双眼上、下睑睑缘三个位置（内侧、中央、外侧）处,各拔取睫毛一根（选择距离睑板腺开口最近的睫毛）。传统Coston法为直接拔出睫毛,改良Coston法为环绕毛囊的螺旋式拔出。睫毛拔下后镜检并计算毛囊蠕形螨各期虫体总数。78例进行改良前后检出特征比较研究,53例进行改良Coston法可重复性分析。所有取样均由同一位具有相关经验的技师操作。采用SPPS20.0对各参数进行统计学描述、比较蠕形螨检出量及阳性率,计算并分析组内相关系数（intraclass correlation coefficient,ICC）值;采用R语言软件比较不同取样的ROC曲线下面积（area under curve,AUC）。主要指标 ICC、AUC、毛囊蠕形螨的阳性率、检出率、检出量。结果 改良Coston法的重复性较高,ICC=0.874,AUC=0.944。取样2根（中央+外侧）时的AUC值与取样3~5根时的差异无统计学意义（P<0.05),且前者可重复性最高（ICC=0.897）。改良后的阳性率及总检出量（82.1%,499.7只）均高于改良前（66.7%,437.28只）（P=0.028,0.000）。结论 改良Coston法拔睫毛镜检的诊断效能高、可重复性好,且可提高蠕形螨检出率。中央及外侧共取样2根的精减取样组合,与传统的内、中、外侧共取样3根的方法相比,具有相似的诊断效力。     

蠕形螨睑缘炎的诊断与治疗研究进展

蠕形螨是一种寄生于人体内的常见寄生虫,根据寄生的部位不同分为毛囊蠕形螨与皮脂蠕形螨。蠕形螨属于条件致病性微生物,部分感染者可无临床症状,但也可引起以睑缘炎为代表的多种常见的眼部疾病,其典型症状包括眼干涩、异物感、袖套样分泌物附着以及眼表刺激症状等。蠕形螨睑缘炎的诊断需根据临床表现及病原学检测共同确定,治疗方法包括植物精油在内多种药物及物理治疗。目前,对于蠕形螨睑缘炎的诊断及治疗方法日渐完善,但蠕形螨感染与其致病性之间的关系尚未明确。本文对目前蠕形螨的特点、蠕形螨睑缘炎的临床表现、诊断、治疗方法及存在的问题进行了总结,希望对未来蠕形螨的进一步研究提供参考依据。     

Polarizable elements in scabies infestation: a clue to diagnosis

The diagnosis of scabies infestation is straightforward in cases where mite parts are largely visible; however, mites are often not captured in a specimen's planes of section. Polariscopic examination is a fast and simple adjunctive diagnostic tool to light microscopy. We describe the unique polariscopic findings in scabies infestation. Two cases of crusted scabies and eight cases of typical scabies were subjected to polariscopic examination. Diagnostic mite parts were visualized in at least one section in all cases. Attached and detached spines as well as scybala (fecal material) are polarizable. Specifically, spines show a polarizable outer sheath with dark central core while scybala show peripherally concentrated, stippled birefringence. Similar stippled birefringence is visible within the gut of some mites whereas significant birefringence is not appreciated in other mite parts. These results suggest that polariscopic examination is a helpful clue in the diagnosis of scabies infestation, especially in cases where the body of the mite is not visualized.     

Demodex spp. Infestation in a breast-cancer patient: A case report

Demodex folliculorum and Demodex brevis are obligatory parasites that live in sebaceous glands and follicles. When immune system becomes suppressed by any reason, patients become vulnerable to obligatory parasites like D. folliculorum and D. brevis. Immune system becomes suppressed in cancer patients who undergo chemotherapy, and as a result these patients become vulnerable to infestations. In our case, a 45 year-old female has been admitted to oncology clinic for a medical treatment of breast cancer. Her systematic physical examination was normal, except redness on her cheeks and forehead. There was no abnormality in biochemical and haematological laboratory values. We have decided to apply chemotherapy of Adriamycin, cyclophosphamide and 5-fluorouracil. Due to the itchy redness on her cheeks and forehead, we had performed an examination for demodex before chemotherapy; and we have identified 20 mites/cm² on her right and left cheeks, and 15 mites/cm² on her forehead. When our patient had came our clinic with increasing complaint of itchy rash, after the first course of chemotherapy we have reexamined demodex. The result of microscopic examination revealed large amount of demodex of 50 mites/cm² on her right and left cheeks and 30 mites/cm² on her forehead, which were nearly 2.5-times higher than the previous examination. This increase probably was associated with immune suppression of chemotherapy.     

Incidence of Demodex Folliculorum in Patients with End Stage Chronic Renal Failure

Background. Demodex folliculorum (DF), found in the pilosebaceous unit, is the most common ectoparasite in humans. It has been implicated in various clinical lesions such as pustular folliculitis, papulopustular scalp eruption, perioral dermatitis, and skin lesions of immunosuppressed patients on chemotherapy or with acquired immunodeficiency syndrome (AIDS). Objective. We aimed to determine DF carriers and location of DF among patients on chronic dialysis because of end stage renal failure (ESRF), to compare them with healthy controls, and to examine the relationship between DF incidence and dialysis method and symptoms. Methods. Sixty-seven patients on dialysis and 67 healthy controls were taken into the study. The patient groups were classified according to the diseases causing ESRF [diabetes mellitus (DM), polycystic disease (PCD), glomerulonephritis (GN), hypertensive nephrosclerosis (HTNS), others (OT), unknown etiology (UE)], and mode of dialysis. Five standardized skin surface biopsies (SSSB) were taken. The determination of five and more living parasites/cm² area was diagnosed as infestation. Results. The mean mite count in the ESRF group, 6.12/cm², was significantly higher than that in controls, 0.31/cm², (Independent Samples Test, p = 0.000). The DF positivity according to primary disease causing ESRF revealed that it was most frequent in DM with 12 patients (44.4%), followed by UE with nine patients (33.4%). Conclusions. Our findings indicate that the DF number is increased in ESRF patients on dialysis treatment. We recommend that demodicidosis should be included in the differential diagnosis of facial eruptions in patients with ESRF.     

面部蠕形螨感染与饮食习惯关系的研究

目的：了解饮食习惯与蠕形螨感染的关系。方法以本科医学生为研究对象,采用透明胶纸挤粘法采集鼻唇沟及鼻尖部位蠕形螨,显微镜下检测虫体,发现成虫、幼虫或者虫卵均为阳性。结果254名学生蠕形螨总感染率为18．50％,其中单一毛囊蠕形螨感染率为14．96％,占总感染数的80．85％;单一皮脂蠕形螨感染率为2．36％,占总感染数的12．77％;两种蠕形螨混合感染率为1．18％,占总感染数的6．38％。农村学生感染率为20.70％,城市学生感染率为10．71％,城市与农村学生感染率差异无统计学意义（P＞0．05）。喜欢食用咸香辛辣食物者感染率为16．92％,不喜欢食用咸香辛辣食物者感染率为20．16％,两种饮食习惯者感染率差异无统计学意义（P＞0.05）。结论人面部蠕形螨感染虫种主要是毛囊蠕形螨,蠕形螨感染与饮食习惯无关。     

蠕形螨相关眼部疾病的研究现状

蠕形螨是一类小型永久性寄生螨,在眼部主要寄居于毛囊、睑板腺及皮脂腺,可引起异物感、眼痒、眼干等眼部症状。近年来越来越多文献报道蠕形螨可引起多种眼部疾病,如睑缘炎、睑板腺功能障碍、霰粒肿、结膜炎、角膜炎、翼状胬肉等,甚至与眼睑基底细胞癌的发生也存在相关性。蠕形螨作为一种致病因素得到越来越多眼科医师的关注。现对蠕形螨相关眼部疾病的研究现状作一综述,旨在提高眼科医师对蠕形螨相关性眼部疾病的认识和重视。