某煤矿矿工足癣现状调查及其病原菌分析

发布时间：2018-11-28 17:17

【摘要】： 足癣是皮肤癣菌侵犯足趾间、足跖、足跟、足侧缘的一种常见的真菌感染性疾病,具有传染性强,发病率高,容易复发和再感染等特点,对患者的生活质量造成很大程度的影响。足癣的主要致病菌为红色毛癣菌,其病原菌菌种构成及分布存在地区差异,而且随着人口流动、环境因素变化及治疗干预等,同一地区的菌种也会发生变迁。目前,关于晋城地区煤矿工人足癣的患病情况及病原学流行病学的详细资料尚未见报道。目的：了解井下煤矿工人足癣患病情况,确定主要致病菌及其分布情况。方法：对2009年6月在山西省长平煤业公司王台医院进行健康体检的1078例矿井下职工进行足癣调查,由皮肤科医生询问病史,进行足部检查,并做出临床诊断可疑者行真菌直接镜检及培养鉴定,同时进行足癣临床类型的调查,填写相关的体检表。提取典型皮损行真菌培养进行致病菌种分析。结果：井下煤矿工人的足癣患病率为25.1%,患者各年龄组、工龄组的患病率随年龄之增长而递增,工龄5年以上者其患病率明显高于5年以下者(P0.01),一线(掘进、采煤)、二线(通风、运输、机电)各工种工人的患病率无差异性(P0.05)。足癣类型以浸渍糜烂型为主,占41.3%。致病菌培养结果显示红色毛癣菌53株(60.9%),须癣毛癣菌26株(29.9%),犬小孢子菌6株(6.9%),白色念珠菌2株(2.3%)。在三种足癣类型中,角化过度型和浸渍糜烂型的致病菌主要是红色毛癣菌,分别占54.5%和73.2%；而水疱鳞屑型的主要致病菌为须癣毛癣菌占54.2%。结论：本次调查显示煤矿工人的患病率为25.1%。较20年前煤矿工人33%～50%的足癣患病率有明显下降,晋城地区煤矿工人足癣的致病菌种中优势致病菌为红色毛癣菌,其次是须癣毛癣菌,在煤矿工人的三种足癣类型中,角化过度型和浸渍糜烂型的致病菌主要是红色毛癣菌,而水疱鳞屑型的主要致病菌为须癣毛癣菌。本调查对煤矿矿工足癣的职业预防和临床诊治具有一定的参考价值。
[Abstract]:Tinea pedis is a common fungal infectious disease that infects the toes, plantar, heel and lateral margin of the foot by dermatophytes. It is characterized by strong infectivity, high incidence, easy recurrence and re-infection. It has a great impact on the quality of life of patients. The main pathogenic bacteria of tinea pedis is Trichophyton rubrum. There are regional differences in the composition and distribution of the pathogenic bacteria, and with the change of population flow, environmental factors and treatment intervention, the species of the same region will also change. At present, the detailed data on the prevalence and etiological epidemiology of tinea pedis among coal miners in Jincheng area have not been reported. Objective: to understand the prevalence of tinea pedis in underground coal miners and determine the main pathogenic bacteria and their distribution. Methods: a total of 1078 workers who underwent physical examination in Wangtai Hospital of Changping Coal Industry Company in Shanxi Province in June 2009 were investigated for tinea pedis. The dermatologist inquired about the history of the disease and examined the foot. The patients with suspicious clinical diagnosis were examined by direct mycological examination and culture, and the clinical types of tinea pedis were investigated, and the relevant physical examination forms were filled out. The typical skin lesions were isolated and cultured for the analysis of pathogenic bacteria. Results: the prevalence rate of tinea pedis in underground coal miners was 25.1%. The prevalence of tinea pedis increased with the increase of age in all age groups and working age groups. The prevalence of tinea pedis was significantly higher in those with more than 5 years of service (P0.01). There was no difference in the prevalence rate of the workers in the second line (ventilation, transportation, electromechanical) (P0.05). The type of tinea pedis was mainly impregnated and erosive, accounting for 41.3%. The results showed that 53 strains (60.9%) of Trichophyton rubrum, 26 strains (29.9%) of Trichophyton rubrum, 6 strains (6.9%) of microsporozoa canis, 2 strains (2.3%) of Candida albicans. Among the three types of tinea pedis, the major pathogens of keratosis and erosion type were Trichophyton rubrum (54.5%) and tinea versicolor (73.2%), while the major pathogenic bacteria of blister scale type were Trichophyton tubuloides (54.2%). Conclusion: the prevalence rate of coal miners is 25. 1%. Compared with 20 years ago, the prevalence of tinea pedis in coal miners was significantly lower than that 20 years ago. The dominant pathogenic bacteria of tinea pedis among coal miners in Jincheng area were Trichophyton rubrum, followed by Trichophyton rubrum, among the three types of tinea pedis of coal miners. The main pathogenic bacteria of keratosis and erosion type were Trichophyton rubrum, while the main pathogenic bacteria of blister scale type were Trichophyton tubuloides. This investigation has certain reference value for occupational prevention, clinical diagnosis and treatment of coal miners' tinea pedis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R756

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