1950～2007年中国深部真菌病历史地理学研究

Historical and geography studies on deep mycosis in China since 1950 to 2007

目的探讨1950～2007年中国深部真菌病的历史地理学规律,为防治该类疾病提供相关理论依据。方法检索1950～2007年中国深部真菌病文献,设置发病年龄、病种、相关发病因素等特征变量,以中间年限1980年和中国八大地区为界,采用SPSS13.0对报道的15778例深部真菌病在不同时段及不同地区间的特征进行分析。结果中国深部真菌病呈逐年增长趋势,在地域上逐渐由集中向分散变化,报道病例数前三位的地区依次为长江中下游地区、中原地区和岭南地区。中国深部真菌病的高发年龄段、病种和相关发病因素具有不同的历史地理学特征,1950～2007年,该病的高发年龄均为中青年,但1980年后,中青年比例下降,儿童和老年病例增多;且报道病种在1980年后明显增多,其中以念珠菌病最多见和最广泛,而鼻孢子菌、球孢子菌、帚霉菌感染区域仍较局限;同时,1980年前外伤是发病主要相关因素,而在1980年后被不洁性接触、抗生素滥用、慢性病等取代。结论中国深部真菌病的发病率将逐年上升,气候湿润、经济发达、人口稠密的长江中下游和中原地区等将成为该类病的主要发病区。将深部真菌病的防治工作与其历史地理学特征结合起来,对从整体上把握该类疾病的发病特征和趋势具有重要意义。

Objective To explore the historical and geography rule of deep mycosis during1950 to2007,and to provide theoretical evidence for better prevention and treatment. Methods All the literature of deep mycosis reported from 1950 to 2007 with 1980 as the intermediate year in China were reviewed. Eight geographical regions of China were set as the dividing line,while age,disease categories and related factors as the variable. All of the 15 778 cases of deep mycosis were analyzed by the SPSS 13. 0. Results The incidence of deep mycosis in China increased yearly and changed gradually from centralized to decentralized in geographical distribution. The most often reported area is the Yangtze River region,followed by the Central Plains region and the Lingnan region. Highrisk population,categories,and factors related to deep mycosis in China differed in history and geography. In 1950-2007,the incidence in the young and middle-aged was high,but declined instead by those in children and the old after 1980. The categories of the disense increased significantly after 1980,of which candidasis was the most common and widespread,while rhinosporosis,copulariopsosis were still confined to restrictive local regions. Injury was the main related factor to deep mycosis before 1980,replaced by sexual contact,abuse of antibiotics,chronic diseases,and more other factors after wards. Conclusions The incidence of deep mycosis in China increases yearly in the regions with humid climate,prosperous economy and densely population,such as the Yangtze River and the Central Plains region. Combined analysis of the historical and geography characteristics is important for prevention and treatment.