中国大陆肺接合菌病102例回顾性分析

中国真菌学杂志　 2014, Vol. 9 　Issue (3): 150-154.

中国大陆肺接合菌病102例回顾性分析

赵静宇^1,2, 王桂祯³, 张俊勇⁴, 杨雅骊¹, 贾红玲¹, 方伟¹, 潘炜华¹, 廖万清¹

1. 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上海市医学真菌分子生物学重点实验室第二军医大学附属长征医院皮肤科, 上海 200003;
2. 上海市皮肤病医院, 上海 200443;
3. 兰州军区乌鲁木齐总医院ICU, 乌鲁木齐 830000;
4. 江苏镇江解放军359医院皮肤科, 镇江 212001

收稿日期:2013-12-18 出版日期:2014-06-28 发布日期:2014-06-28
通讯作者: 廖万清，E-mail：liaowanqing@sohu.com；方伟，E-mail：weifang081782@gmail.com E-mail:liaowanqing@sohu.com;weifang081782@gmail.com
作者简介:赵静宇，女（满族），硕士研究生在读.E-mail：zjyhzq@126.com
基金资助:
国家973项目（2013CB531601）；上海市自然科学基金（12ZR1454400，12JC1411000）；上海市医学真菌分子生物学重点实验室基金（14DZ2272900）；重大传染病防治科技重大专项（2013ZX10004612）

Retrospective analysis of pulmonary zygomycosis in mainland China：a review of 102 cases

ZHAO Jing-yu^1,2, WANG Gui-zhen³, ZHANG Jun-yong⁴, YANG Ya-li¹, JIA Hong-ling¹, FANG Wei¹, PAN Wei-hua¹, LIAO Wan-qing¹

1. Department of dermatology, Changzheng Hospital, Institute of dermatology and medical mycology, Changzheng Hospital, Key laboratory of molecular medical mycology, PLA key laboratory of medical mycology, Shanghai key laboratory of Molecular Mycology, Shanghai 200003;
2. Shanghai Skin Disease Hospital, Shanghai 200443;
3. Intencive Care Unit, Urumuqi Army General Hospital, Lanzhou Military District, Wulumuqi, 830000;
4. 359 hospital of PLA, Zhenjiang 212001

Received:2013-12-18 Online:2014-06-28 Published:2014-06-28

摘要/Abstract

摘要：

目的总结与探讨中国大陆地区近25 a肺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1988年以来的中国大陆地区肺接合菌病的相关文献资料。结果共检索文献73篇，病例102例。患者的平均发病年龄为48.4岁，男女比例为2.46：1，总死亡率为40.82%。我国肺接合菌病多见于糖尿病、HIV感染、病毒性肝炎、长期使用糖皮质激素和（或）免疫抑制剂等伴基础疾病的人群。其临床及影像学检查无特异性，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肺接合菌病发病率呈上升趋势。对高度怀疑肺接合菌感染的患者，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, 肺部感染, 中国

Abstract:

Objective To investigate the epidemiology and clinical characteristics of pulmonary zygomycosis in mainland China.Methods Literatures about pulmonary zygomycosis in China were collected from the electrical databases, such as CNKI, CJDF, VIP, Chinese physician full-text journals, and also Pubmed since 1988. Then all the data were analyzed with the SPSS 15.0 software.Results Seventy-three articles (102 cases) were included in the study. Median age was 48.4 (range, 0.003-84) years old, with a male predominance (M：F=2.46). In China, patients with diabetes, HIV infection, viral hepatitis, and long-term utilization of corticosteroid and/or immunosuppressants, were more susceptible to pulmonary zygomycosis. 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 pulmonary 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 pulmonary zygomycosis in mainland china. For highly suspected pulmonary zygomycosis, it's necessary to initiate early anti-fungal therapy, and combined surgical treatment may improve the outcome.

Key words: Zygomycosis, Mucor, pulmonary infection, China

中图分类号:

R519.8

赵静宇, 王桂祯, 张俊勇, 杨雅骊, 贾红玲, 方伟, 潘炜华, 廖万清. 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.

ZHAO Jing-yu, WANG Gui-zhen, ZHANG Jun-yong, YANG Ya-li, JIA Hong-ling, FANG Wei, PAN Wei-hua, LIAO Wan-qing. Retrospective analysis of pulmonary zygomycosis in mainland China：a review of 102 cases[J]. Chinese Journal of Mycology, 2014, 9(3): 150-154.

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