甲真菌病719例临床及致病真菌分析

目的了解天津地区甲真菌病的临床分类、菌种构成及其分布。方法对直接镜检阳性的719例甲真菌病患者进行了真菌培养、鉴定和临床分析。结果719例患者中真菌培养阳性510例,阳性率70.93%,皮肤癣菌、酵母、非皮肤癣菌霉菌(NDM)所占比例分别为76.24%,16.47%和7.25%。皮肤癣菌中红色毛癣菌占81.30%(326/401),酵母菌中以白念珠菌居首,占44.29%(31/70),非皮肤癣菌中以青霉和曲霉为主。临床类型以远端侧位甲下型甲真菌病(DLSO)最为常见。就诊人群中以36岁～55岁年龄段为主,占42.75%(218/510)。男性发病率(67.25%)总体高于女性(32.75%),且各年龄段患者的致病菌均以皮肤癣菌为主。结论天津地区甲真菌病的临床类型以DLSO为主,不同年龄、性别存在差异,红色毛癣菌为优势致病菌,符合国内流行趋势。

Clinical Investigation on 719 Cases of Onychomycosis and Analysis of Pathogenic Fungus

Objective To analyze the clinical features,pathogenic fungus distribution and correlation between fungus and clinical patterns of onychomycosis in Tianjin.Methods Fungal culture and clinical analysis were performed on 719 cases of onychomycosis with positive result by direct microscopic examination from Dec 2006～Dec 2007.Results Of all the 719 cases of onychomycosis,the positive fungal cultures were 510,the positive rate was 70.93%.The rates of dermatophytes,yeast and non-dermatophytic moulds(NDM) were 76.24%,16.47%,and 7.25%,respectively.Dermatophytes were the dominate strains.DLSO were the most frequently clinical patterns.Conclusion In Tianjin region,the dominant clinical type of onychomycosis is DLSO and there are differences between patients with different sex and age The most frequent pathogenic fungus of onychomycosis is trichophyton,which is consistent with current trend in China.