大型酿酒企业工人感染皮肤癣菌病的现状与对策

Present status and countermeasure of liquor workers with dermatophytosis from large companies

目的:了解大型酿酒企业工人感染皮肤癣菌病的种类、发病率、传播途径及治疗手段的有效性。方法:于2005-03/06选择泸州地区数家大型酿酒企业的酿酒工人628名和企业行政职员436名为调查对象。采用自行设计的调查表记录调查对象的性别、年龄、皮肤真菌感染的皮损情况,并询问其治疗情况和身体状况。对所患手癣、足癣、体癣、股癣、花斑癣和甲癣进行真菌检测。外搽硝酸咪康唑乳膏,2～3次/d,总疗程为4周,每2周随访1次。疗效判断以痊愈为临床症状消失,皮损全部消退,真菌检查阴性;显效为临床症状基本消失,皮损明显消退,真菌检查阴性;好转为临床症状减轻,皮损部分消退,真菌检查阳性;无效为临床症状无变化,皮损未消退,真菌检查阳性。结果:酿酒工人628名和企业行政职员436名均进入结果分析。①皮肤癣菌病的发病情况:酿酒工人628名,患皮肤癣菌病468名(74.52%),企业行政职员436名,患皮肤癣菌病210名(48.23%),两者比较差异显著(P<0.01)。②皮肤癣菌病的发病种类:酿酒工人足癣的患病率很高(72.62%),其次是花斑癣(15.35%);企业行政职员足癣患病率也较高(39.52%),其次是体癣(22.38%)和股癣(20.40%)。③手足癣的临床分型:酿酒工人和企业行政职员足癣均以角化过度型为多见;而手癣则均以水疱型为多见。④皮肤癣菌病与病原菌的分布关系:病原菌主要是红色毛癣菌。⑤皮肤癣菌患者外用药物疗效观察结果:企业行政职员外用药治疗的有效率(73.33%)高于酿酒工人(54.06%)。结论:酿酒企业的生产环境温度偏高而潮湿,酿酒工人易于感染皮肤癣菌病,应加强皮肤癣菌病的预防和治疗,努力改善酿酒的生产环境。

AIM： To investigate type, incidence rate, transmission way of dermatophytosis for liquor workers in large companies, and explore the efficiency of therapeutic method. METHODS： Totally 628 liquor workers from large companies of Luzhou area and 436 administrative staffs from companies were enrolled as investigational subjects between March and June 2005. Self-made＂ questionnaire was applied to record the sex, age, injured status of infected skin and to require their therapeutic condition and physical status. The fungus of tinea manus, tinea pedis, tinea corporis, tinea eruris, tinea versieolor and tinea unguium were examined. Mieonazole nitrate cream was taken outward, 2-3 times per day for 4 weeks, and follow-up was done every 2 weeks. Fully recovery was showed that disappearance of clinical symptom, the injured skin disappeared, eumyeete detection was as negative. Significant efficiency was showed that mostly elimination of clinical symptom, significant extinction of injured skin, eumyeete detection was as negative. Improvement was showed clinical symptom decreased, subsidence of injured skin, eumyeete detection was as positive. Inefficacy represented no change of clinical symptom, no subsidence of injured skin, eumyeete detection was as positive. RESULTS： A total of 628 liquor workers and 436 administrative staffs from companies were included in the result analysis. ① Incidence of dermatophytosis： Of 628 liquor workers, 468 workers were with dermatophytosis （74.52%）. Of 436 administrative staffs from companies, 210 were with dermatophytosis （48.23%）. There was significant difference between the both （P 〈 0.01 ）. ②Episode sort of dermatophytosis： The incidence rate of liquor workers was higher （72.62%）, followed by tinea versieolor （15.35%）. The incidence rate of administrative staffs of companies was also high （39.52%）, followed by tinea eorporis （22.38%） and tinea eruris （20.40%）. ③Clinieal classification of dermatophytosis： The tinea pedis of liquor workers and administrative staffs of companies was hyperkeratotie pattern mostly, while tinea manus was blister type mostly. ④ Distributive relationship between dermatophytosis and pathogenic bateria： The pathogenic bateria was triehophyton rubrum. ⑤Curative effect observation of drug for exterior use for dermatophytosis patients： Effective rate of drug for exterior use in administrative staffs from companies （73.33%） was higher than that in the liquor worker （54.06%）. CONCLUSION： The liquor workers can be infected by dermatophytes easily, because of the higher productive environmental temperature and moisture. It is very important to strengthen the prevention and treatment for dermatophytosis, and urgently ameliorate the productive environment.