中国大陆肝炎患者合并接合菌感染19例回顾性分析

中国真菌学杂志　 2015, Vol. 10 　Issue (1): 31-34.

中国大陆肝炎患者合并接合菌感染19例回顾性分析

胡尊琪¹, 赵静宇^2,3, 方伟², 潘炜华², 廖万清², 蔡清萍¹

1. 上海市长征医院胃肠外科, 上海 200003;
2. 上海长征医院皮肤病与真菌病研究所全军真菌病重点实验室第二军医大学附属长征医院皮肤科, 上海 200003;
3. 上海市皮肤病医院, 上海 200050

收稿日期:2014-11-25 出版日期:2015-02-28 发布日期:2015-02-28
通讯作者: 蔡清萍,E-mail:caiqingpingwcwk@163.com;廖万清,E-mail:liaowanqing@sohu.com E-mail:caiqingpingwcwk@163.com;liaowanqing@sohu.com
作者简介:胡尊琪,男(汉族),硕士研究生在读.E-mail:xiaoqiyhe@163.com
基金资助:
国家973项目(2013CB531601);上海市自然科学基金(12ZR1454400,12JC1411000)

Retrospective analysis of hepatitis complicated with zygomycosis in mainland China:a review of 19 cases

HU Zun-qi¹, ZHAO Jing-yu^2,3, FANG Wei², PAN Wei-hua², LIAO Wan-qing², CAI Qing-ping¹

1. Department of General Surgery, Changzheng Hospital, Shanghai 200003;
2. Shanghai key laboratory of Molecular Mycology, Department of Dermatology, Changzheng Hospital, Shanghai 200003;
3. Shanghai Skin Disease and STD Hospital, Shanghai 200050

Received:2014-11-25 Online:2015-02-28 Published:2015-02-28

摘要/Abstract

摘要： 目的总结与探讨中国大陆地区近10余年间病毒肝炎合并接合菌病的流行病学特点及诊疗情况.方法检索分析重庆维普、CNKI系列数据库、万方数据库、中国医师协会全文期刊库及Pubmed等数据库中2000年以来的中国大陆地区肝炎合并接合菌病的相关文献资料.结果共检索文献10篇,病例19例.患者的平均发病年龄为37.6岁,男女比例为18:1,总死亡率为78.95%.其临床表现无特异性,诊断主要依赖于真菌学及组织病理学检查.治疗方法首选两性霉素B,联合手术治疗较之单独抗真菌药物疗效更好.结论近年来中国大陆地区肝炎合并接合菌病发病率呈上升趋势.对肝炎并高度怀疑接合菌感染的患者,宜尽早启动抗真菌治疗,及时联合病灶切除者疗效更佳.

关键词: 接合菌病, 毛霉, 肝炎, 中国

Abstract: Objective To investigate the epidemiology and clinical characteristics of hepatitis complicated with zygomycosis in mainland China.Methods Literatures about hepatitis complicated with zygomycosis in China were collected from the electrical databases,such as CNKI,CJDF,VIP,Chinese physician full-text journals,and also Pubmed since 2000.Results 10 articles (19 cases) were included in the study.Median age was 37.6 (range,20-62) years old,with a male predominance (M:F=18:1).Without specific clinical and radiographic features,its diagnosis was mainly dependent on mycologic and/or histopathological examination.Amphotericin B was the first-line antifungal drug for hepatitis complicated with zygomycosis,and better efficacy could be got if combined with surgical treatment.Conclusions In recent years,there is an increasing trend in the prevalence of hepatitis complicated with zygomycosis in mainland china.For highly suspected hepatitis complicated with zygomycosis,it's necessary to initiate early anti-fungal therapy,and combined surgical treatment may improve the outcome.

Key words: zygomycosis, mucor, hepatitis, China

中图分类号:

R519.8

胡尊琪, 赵静宇, 方伟, 潘炜华, 廖万清, 蔡清萍. 中国大陆肝炎患者合并接合菌感染19例回顾性分析[J]. 中国真菌学杂志, 2015, 10(1): 31-34.

HU Zun-qi, ZHAO Jing-yu, FANG Wei, PAN Wei-hua, LIAO Wan-qing, CAI Qing-ping. Retrospective analysis of hepatitis complicated with zygomycosis in mainland China:a review of 19 cases[J]. Chinese Journal of Mycology, 2015, 10(1): 31-34.

参考文献

[1] Spellberg B,Edwards J Jr,Ibrahim A.Novel perspectives on mucormycosis:pathophysiology,presentation,and management[J].Clin Microbiol Rev,2005,18(3):556-569.
[2] Chayakulkeeree M,Ghannoum MA,Perfect JR.Zygomycosis:the re-emerging fungal infection[J].Eur J Clin Microbiol Infect Dis,2006,25(4):215-229.
[3] Ameen M,Arenas R,Martinez-Luna E,et al.The emergence of mucormycosis as an important opportunistic fungal infection:five cases presenting to a tertiary referral center for mycology[J].Int J Dermatol,2007,46(4):380-384.
[4] Liang X,Bi S,Yang W,et al.Epidemiological serosurvey of hepatitis B in China--declining HBV prevalence due to hepatitis B vaccination[J].Vaccine,2009,27(47):6550-6557.
[5] De Pauw B,Walsh TJ,Donnelly JP,et al.Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group[J].Clin Infect Dis,2008,46(12):1813-1821.
[6] Roden MM,Zaoutis TE,Buchanan WL,et al.Epidemiology and outcome of zygomycosis:a review of 929 reported cases[J].Clin Infect Dis,2005,41(5):634-653.
[7] Rees JR,Pinner RW,Hajjeh RA,et al.The epidemiological features of invasive mycotic infections in the San Francisco Bay area,1992-1993:results of population-based laboratory active surveillance[J].Clin Infect Dis,1998,27(5):1138-1147.
[8] Greenberg RN,Scott LJ,Vaughn HH,et al.Zygomycosis (mucormycosis):emerging clinical importance and new treatments[J].Curr Opin Infect Dis,2004,17(6):517-525.
[9] 赵静宇,王桂祯,张俊勇,等.中国大陆肺接合菌病102例回顾性分析[J].中国真菌学杂志,2014,9(3):150-154.
[10] di CA,Costantino F,Tarani L,et al.Rhinocerebral zygomycosis with pansinusitis in a 14-year-old girl with type 1 diabetes:a case report and review of the literature[J].Ital J Pediatr,2013:doi:10.1186/1824-7288-39-77
[11] Dannaoui E,Meletiadis J,Mouton JW,Meis JF,Verweij PE.In vitro susceptibilities of zygomycetes to conventional and new antifungals[J].J Antimicrob Chemother,2003,51(1):45-52.
[12] Singh J,Rimek D,Kappe R.In vitro susceptibility of 15 strains of zygomycetes to nine antifungal agents as determined by the NCCLS M38-A microdilution method[J].Mycoses,2005,48(4):246-250.
[13] Page RL 2nd,Schwiesow J,Hilts A.Posaconazole as salvage therapy in a patient with disseminated zygomycosis:case report and review of the literature[J].Pharmacotherapy,2007,27(2):290-298.
[14] van Burik JA,Hare RS,Solomon HF,Corrado ML,Kontoyiannis DP.Posaconazole is effective as salvage therapy in zygomycosis:a retrospective summary of 91 cases[J].Clin Infect Dis,2006,42(7):e61-65.
[15] Severo LC,Oliveira FD,Dreher R,Teixeira PZ,Porto ND,Londero AT.Zygomycosis:A report of eleven cases and a review of the Brazilian literature[J].Rev Iberoam Micol,2002,19(1):52-56.