次氯酸钙抗真菌的体外实验与临床应用

Experimental Study of the in Vitro Antifungal Activities and Clinical Observation of Calcium Hypochlorite

目的 :探讨次氯酸钙的抗真菌作用及机制。方法 :采用琼脂双倍稀释法及中和剂悬液法培养对 6种常见致病性真菌进行抑菌实验 ;观察最小抑菌浓度作用下 ,3种致病真菌的超微结构变化 ;随机分组比较次氯酸钙与克霉唑、制霉菌素治疗皮肤浅部真菌病的临床疗效。结果 :次氯酸钙对红色毛癣菌、石膏样小孢子菌、羊毛状小孢子菌、絮状表皮癣菌有抑制和杀灭作用 ,其最低抑菌稀释度为 1∶4 0 0 ;对白色念珠菌和孢子丝菌均有抑制作用 ,最低抑菌稀释度分别为1∶10 0 ,1∶5 0 ;能破坏红色毛癣菌、石膏样小孢子菌及白色念珠菌的细胞壁 ,使细胞质、细胞核空泡化 ,细胞器变性 ;随机分组对比治疗皮肤浅部真菌病 ,其效果与对照组相似 (P >0 .0 5 )。结论 :次氯酸钙具有抗真菌作用 ,能杀灭常见浅部致病真菌 ,抑制常见深部致病真菌。临床应用效果确切 ,副作用小 ,安全。

Objective: To probe into the antifungal activities of calcium hypochlorite and the underlying mechanisms. Methods:6 kinds of common pathogenic fungi were cultured with the agar double dilution method and the neutralizer suspension method for antifungal tests. The ultrastructure of three species of the pathogenic fungi in a medium with minimal fungistatic concentration was studied by transmission electron microscopy (TEM).Randomly divided groups of patients with superficial dermatomycosis were subjected to clinical observation on the curative effects of calcium hypochlorite. Results: Calcium hypochlorite was shown to have fungistatic and fungicidal effects on Trichomycetes rubrum, Microsporum gypseum, Microsporum lanosum and epidermophyton floccosum at a minimal fungistatic concentration of 1∶400. Calcium hypochlorite had also fungistatic effects on Candida albicans and sporotrichum schenckii at minimal fungistatic concentrations of 1∶100 and 1∶50,.respectively Destruction of the cell wall, vacuolization of the cytoplasm and nucleus, degeneration of organelles were demonstrated in T.rubrum, M.gypseum and C.albicans under the election microscope. The differences between the curative effects of calcium hypochlorite in the treatment of 43 patients with superficial dermatomycosis and those seen in the control patients were insignificant (P>0.05). Conclusion:Calcium hypochlorite was found to possess antifungal activities, being capable of killing common superficial pathogenic fungi, and inhibiting deep pathogenic ones. Its clinical curative effects are definite, with only mild side effects. It seems to be a new drug of choice for disinfecting body surface and environmental fungi as well as for clinical treatment of superficial dermatomycosis.