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目的了解天津地区甲真菌病致病菌流行趋势及病甲形态与致病菌的相关性。方法对本院皮肤科门诊就诊的4 100例甲真菌培养结果阳性患者的临床资料、真菌培养结果等进行统计与分析。结果共分离菌株4 625株,其中皮肤癣菌2 998株(64.82%),以红色毛癣菌为主,共2 422株(80.79%);酵母菌1 309株(28.30%),以白念珠菌为主,共1 099株(83.96%);其他(包括曲霉、短掃霉等)318株(6.88%)。在临床分型上主要以远端侧位甲下型(DLSO)为主。远端侧位甲下型、白色浅表型(SWO)主要由皮肤癣菌感染引起,全甲营养不良型(TDO)、近端甲下型(PSO)主要由酵母菌感染引起。皮肤癣菌感染时病甲多呈黄色或黄褐色,一般无绿、黑色等特殊改变,酵母菌感染时病甲可呈黄色或黄褐色,但亦可见绿、黑色等特殊改变。结论与天津地区既往研究相比较,红色毛癣菌仍为优势致病菌,但比例有所下降,酵母菌的比例升高。根据病甲的临床分型、形态学变化、颜色改变可以大致推断致病菌的种类。
Objective To understand the epidemic trend of onychomycosis and the relationship between the pathogen A and pathogenic bacteria in Tianjin. Methods The clinical data of 4 100 positive cases of onychomycosis and the results of fungal culture were collected and analyzed in our dermatology clinic. Results A total of 4 625 strains of dermatophytes were isolated, of which 2 998 (64.82%) were Dermatophytes, of which 2 422 (80.79%) were Trichophyton rubrum, 309 (28.30%) were yeast, A total of 1 099 strains (83.96%) were found, among which 318 strains (6.88%) were other (including Aspergillus oryzae). In the clinical classification of the main type of distal lateral hypothyroidism (DLSO) based. Distal lateral hypothyroidism and white superficiality (SWO) are mainly caused by dermatophytes, TDO and PSO are mainly caused by yeast infection. When dermatophytes are infected, most of them are yellow or brown. Most of them are greenish and black, but they may be yellow or brown when they are infected with yeast. However, special changes such as green and black can also be seen. Conclusion Compared with the previous studies in Tianjin, Trichophyton rubrum is still the predominant pathogen, but its proportion has decreased and the proportion of yeast increased. According to the clinical classification of disease A, morphological changes, color changes can be roughly inferred pathogenic bacteria species.