任意引物聚合酶链反应法对职业性皮肤癣病的诊断价值

Detection of fungi in liquor workers with tinea corporis andtinea cruris using arbitrarily primed polymerase chain reaction

目的探讨任意引物聚合酶链反应（AP-PCR）法对职业性皮肤癣病的诊断价值及在普查诊断酿酒工人皮肤癣菌病中的意义。方法用任意引物OPD18（5’-GAGAGCCAAC-3’）和OPAAll（5’-AcccGAccTD3’）对50例患体癣和58例患股癣的酿酒工人所感染的致病皮肤癣菌进行AP-PCR法检测，同时用直接镜检法检测真菌并用传统的培养法进行培养；并且与50名健康人皮屑的检测结果作对比。结果在50例临床诊断为体癣工人的皮屑中，用AP-PCR方法检测真菌阳性的例数为45例（90．00％），检测出的真菌菌种分别为红色毛癣菌、须癣毛癣菌、犬小孢子菌和絮状表皮菌；作真菌直接镜检的阳性例数为31例（62．00％）；作真菌培养的阳性例数为41例（82．00％），培养出的真菌菌种分别为红色毛癣菌、须癣毛癣菌和犬小孢子菌。在58例临床诊断为股癣的工人皮屑中，用AP-PCR方法检测真菌阳性的例数为53例（91．38％），检出的真菌菌种分别为红色毛癣菌、絮状表皮癣菌和须癣毛癣菌；作真菌直接镜检的阳性例数为37例（63．79％）；作真菌培养的阳性例数为48例（82．76％），培养出的真菌菌种为红色毛癣菌、絮状表皮癣菌和须癣毛癣菌。50例健康人皮屑用AP-PCR方法检测阳性例数为3例（6．00％），检测的菌种2例为红色毛癣菌，l例为须癣毛癣菌；直接镜检未检出阳性者；用培养法检出阳性者1例（2．00％），菌种为红色毛癣菌。结论AP-PCR方法对于职业性皮肤癣菌病患者具快速诊断的价值，且具有较好的敏感性和特异性，可用于职业性皮肤癣菌病的检测和诊断。

Objective To explore the method of rapid detection of skin fungi and the significance of conventional diagnosis liquor worker tinea corporis and tinea cruris using arbitrarily primed polymerase chain reaction（AP-PCR）. Methods Among liquor workers who were 50 tinea corporis patients, 58 tinea cruris pa- tients and 50 health persons, we amplified the DNAs of the dermatophytes were amplified using AP-PCR and random primers OPD18（5 ＇-GAGAGCCAAC-3 ＇） and OPAA11 （5 ＇-ACCCGACCTG-3 ＇）, at the same time, the demmtophytes with microscope were detected and cultured. Results AP-PCR analysis detected fungal DNA in 45 patients（90.00%） among 50 liquor worker patients with tinea corporis, 31 patients（62.00%） had the positive results of microscope detection,and 41 patients（82.00%） had the positive results of standard culture.Among these workers who suffered from tinea corporis, T.rubrum,T.mentagrophyte, M. canis and E.fioccosum were detected by AP-PCR.T.rubrum, T.mentagrophyte and M.canis were detected by standard cuhure.AP-PCR analysis detected fungal DNA in 53 patients（91.38%） among 58 liquor worker patients with tinea cururis, 37 patients （63.79%） had the positive results of microscope detection, and 48（82.76%） had the positive results of standard culture. Among the 58 workers who had tinea cruris, T.rubrum, E.iloccosum and T.mentagrophyte were detected by AP-PCR and standard culture. Among 50 health persons, AP-PCR analysis detected fungal DNA in 3 persons （6.00%）. The detection result with AP-PCR indicated that the kinds of fungi were T.rubrum and T. mentagrophyte. No one health person had the positive result in detection of fungi using microscope detection. Only one（2.00%） health person was detected tobe infected by fungus with cultural way.The kind of fungus was T.rubrum. Conclusion AP-PCR is a rapid, sensitive and specific detection method for occupational dermatophyte patients.h can be used to detect and diagnose professional dermatophytosis.