2型糖尿病患者甲真菌病临床资料分析

Clinical data analysis of onychomycosis in patients with type 2 diabetes

目的了解糖尿病患者甲真菌病的临床分型、菌种构成及易感因素。方法分析2013年1月至2014年8月山西医科大学第二医院内分泌科2型糖尿病住院患者的临床资料,对合并甲真菌病者进行临床分型、菌种鉴定,对可能导致糖尿病患者甲真菌感染的因素进行Logistic回归分析。结果 1 125例2型糖尿病患者中合并有甲真菌病者153例,患病率为13.6%;临床分型为远端侧缘甲下型94例(58.39%),全甲毁损型43例(26.71%),白色浅表型18例(11.18%),近端甲下型6例(3.72%);菌种鉴定为皮肤癣菌属77例(67.54%),是主要的致病菌,酵母菌属(23.68%)和曲霉菌属(3.51%)相对要少;多因素分析结果表明年龄、男性、糖尿病病程、周围循环障碍、周围神经病变、视网膜病变与糖尿病患者患甲真菌病有关(P<0.05)。结论糖尿病患者甲真菌病的易感因素包括年龄、男性、糖尿病病程、周围循环障碍、周围神经病变、视网膜病变。

Objective To analyze the clinical classification, pathogenic fungal profile and predisposing factors of onychomycosis in patients with type 2 diabetes. Methods The analysis was performed basing on the clinical data of hospital patients with type 2 diabetes in department of endocrinology from January 2013 to August 2014. Assessed clinical classification and identifying fungi strains of the patients with onychomycosis. Analyzed the possible factors leading to incurrence of fungal infection in patients with type 2 diabetes and all these factors were statistics by Logistic regression analysis. Results A total of 1 125 cases of patients with type 2 diabetes were investigated and 153 patients had a fungal infection and the incidence rate of onychomycosis was 13.6%;DLSO were the most clinical classification （58.39%）, followed by TDO （43 cases, 26.71%）, SWO （18 cases, 11.18%） and PSO （6 cases, 3.72%）; Dermatophytes were still the main pathogen and there were 77 patients infected by dermatophytes. Yeast （23.68%） and aspergillus （3.51%） were less than dermatophytes. Multi-factor analysis showed that age, male gender, duration of diabetes, peripheral circulatory disturbance, peripheral neuropathy, retinopathy were the predisposing factors of onychomycosis in patients with type 2 diabetes （P〈0.05）. Conclusion The predisposing factors of onychomycosis in patients with type 2 diabetes include age, male gender, and duration of diabetes, peripheral circulatory disturbance, peripheral neuropathy and retinopathy.