天津地区浅部真菌病发病情况调查

发布时间：2018-01-15 02:28

本文关键词：天津地区浅部真菌病发病情况调查　出处：《天津医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的调查天津地区的浅部真菌病患者组成与病种分布情况,分析各类型浅部真菌病在不同性别、年龄、季节等条件下的变化趋势,从而提供理论依据以提升临床医生对浅部真菌病的认识,也为抗真菌药物的使用提供较安全与合理的参考数据,对浅部真菌病达到及早诊断及早治疗的目的。方法选取2012年1月-2012年12月期间至天津医科大学总医院皮肤科就诊的患者,对拟诊浅部真菌病患者进行真菌化验检查,取患处的皮屑、指(趾)甲屑、毛发、黏膜分泌物等标本,进行显微镜下检查,必要时移至沙氏琼脂SDA培养基进行真菌培养,结果为阳性者列入统计资料,收集其性别、年龄、职业等基本资料,依照病种、发病季节、性别、年龄等指标进行系统整理与分类,软件采用SPSS16.0统计软件进行分析,按α=0.05检验水准,P0.05则差别具有统计学意义。结果真菌直接镜检为阳性或真菌培养结果为阳性的病例共计1152例,男性患者为608例,女性患者为544例,年龄1—84岁,其中生殖器念珠菌病占首位,共413例,占全部病例的35.8%,第二位为甲癣,共179例,占15.5%,第三位为股癣,共163例,占14.1%,第四位为足癣,共146例,占12.6%,第五位为体癣,共103例,占8.9%,第六位为花斑癣,共54例,占4.6%,第七位为手癣,共38例,占3.2%,第八位为马拉色菌毛囊炎,共25例,占2.1%,第九位为头癣,共21例,占1.8%,第十位为口腔念珠菌病,共10例,占0.8%。男性患者占59.2%,女性患者占40.8%。男性浅部真菌病患病率高于女性,男女两性之间存在统计学上差异(P0.01)。不同年龄层分组中,青幼年组病例数为202例(占17.5%),青中年组病例数为711例(占61.7%),老年组病例数为239例(占20.8%),不同年龄层组之间存在的差异是具有统计学意义的(P0.01),从低年龄层到高年龄层的浅部真菌病病大部分皆呈现先上升后下降的发病趋势,且于青中年组(19岁-50岁)年龄层段达到峰值后逐渐下降。各类浅部真菌病第一季度到第二季度呈现陡峭的上升趋势,在第三季度的水平最高,至第四季度过程中呈现下落趋势。在各临床类型甲癣中,远端侧位甲下型(DLSO),共118例,占总患病比率的65.9%,在发病数上趾甲甲癣高于指甲甲癣,足癣临床分型中则以水疱鳞屑型占据最高的优势地位,共89例,占总患病比率的60.9%。结论本文通过对天津医科大学总医院皮肤科病人浅部真菌病的流行病学调查,发现生殖器念珠菌病在天津地区有着较高的发病率,除此之外甲癣、股癣、足癣的发病率居前三位,此外浅部真菌病的发病率分布受性别、年龄、季节、职业等因素影响,根据统计分析显示男女之间在病种的发病率方面存在差异,患病高发年龄层在青中年组(19岁～50岁),高发季节为2、3季度,浅部真菌病分布趋势虽具备自身特点,但大致符合国内外其他相关研究,本研究为本地区的临床医生提高对浅部真菌病的认识,给予诊断治疗的合理化依据和借鉴。
[Abstract]:Purpose To investigate the composition and distribution of superficial mycosis in Tianjin area, and analyze the change trend of different types of superficial mycosis under different sex, age, season and other conditions. Thus, the theoretical basis is provided to enhance the clinicians' understanding of superficial mycosis, to provide safe and reasonable reference data for the use of antifungal drugs, and to achieve the purpose of early diagnosis and treatment of superficial mycosis. Method From January 2012 to December 2012, the patients who went to the Department of Dermatology, General Hospital of Tianjin Medical University, were examined by fungal test and the dander of the affected area was taken. Finger (toe) nail dust, hair, mucosal secretions and other specimens were examined under the microscope, when necessary moved to the salsa Agar SDA medium for fungal culture, the results showed that the positive cases were included in the statistical data and collected their sex. Age, occupation and other basic data, according to the disease, disease season, sex, age and other indicators for systematic sorting and classification, the software was analyzed by SPSS16.0 statistical software. The difference was statistically significant according to 伪 -0.05 test level (P0.05). Results There were 1152 cases of positive fungi or positive fungal culture, 608 cases of male patients and 544 cases of female patients aged 1-84 years. Among them genitalia candidiasis accounted for the first 413 cases accounting for 35.8m the second was onychomycosis 179 cases (15.5%) and the third was tinea cruris (163 cases). Accounting for 14.1, 4th for tinea pedis, a total of 146 cases, accounting for 12.6, 5th for tinea corporis, a total of 103 cases, accounting for 8.9, 6th for tinea versicolor, a total of 54 cases, accounting for 4.6%. 7th cases were tinea capitis (38 cases, 3.2%), 8th cases were Malassezia folliculitis (25 cases, 2.1%), 9th cases were tinea capitis (21 cases, 1.8%), 10th cases were oral candidiasis. There were 10 cases (0.8%). 59.2% of male patients and 40.8% of female patients. The prevalence of superficial mycosis in males was higher than that in females. There was statistical difference between male and female (P 0.01). In different age groups, 202 cases (17.5%) were young and young. There were 711 cases (61.7%) in the middle-aged group and 239 cases (20.8%) in the elderly group. The difference between different age groups was statistically significant (P 0.01). Most of the superficial mycosis from the lower age group to the high age group showed the trend of rising first and then decreasing. After reaching the peak, all kinds of superficial mycosis showed a steep upward trend from the first quarter to the second quarter, the highest level in the third quarter. Among the clinical types of onychomycosis, there were 118 cases of distal lateral subnail type of DLSO, accounting for 65.9% of the total incidence. The incidence of toenail and tinea was higher than that of nail nail and tinea pedis had the highest dominant position in clinical classification of psoriasis with blister scale type (89 cases) accounting for 60.9% of the total incidence. Conclusion Through epidemiological investigation of superficial mycosis in dermatology department of General Hospital of Tianjin Medical University, we found that genital candidiasis has a high incidence in Tianjin, in addition to onychomycosis and tinea cruris. The incidence of tinea pedis is the first three. In addition, the incidence of superficial mycosis is affected by sex, age, season, occupation and so on. According to the statistical analysis, there are differences in the incidence of diseases between men and women. The age group with high incidence of the disease was 19 years old and 50 years old, and the high incidence season was 2 ~ 3 seasons. Although the distribution trend of superficial mycosis had its own characteristics, it was roughly in line with other related studies at home and abroad. This study provides reasonable basis for diagnosis and treatment of superficial mycosis for clinicians in this area.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R756

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