中国大陆地区暗色丝孢霉病(1987～2017年)回顾性分析

A retrospective analysis of phaeohyphomycosis in the Mainland of China(1987-2017)

目的了解中国大陆地区近30年暗色丝孢霉病的流行病学和诊治状况。方法通过CNKI、万方、维普、Embase和Pubmed检索1987～2017年中国大陆地区暗色丝孢霉病相关文献,进行数据分析和总结。结果共纳入文献106篇,共计有115例患者。感染类型以皮肤及皮下组织型为主,继发于皮肤屏障被破坏、特发性免疫功能异常最多。诊断主要依据真菌镜检、组织病理、真菌培养和分子鉴定。治疗以系统抗真菌药物为主,伊曲康唑为首选用药。107例患者中因该病死亡10例,占9.35%;其中以中枢神经系统型死亡率最高,达75%。结论中国大陆地区暗色丝孢霉病感染数有明显上升趋势。临床医生应提高该病各型临床及病原诊断水平,并积极开展分子鉴定和体外药物敏感性试验,为临床治疗提供更为有效的依据。

Objective To understand the epidemiology and treatment of phaeohyphomycosis in the mainland of China over 30 years.Methods Literature on phaeohyphomycosis of the Chinese mainland from 1987 to 2017 were collected by CNKI,WanFang,WeiPu,Embase and Pubmed and statistically analyzed.Results A total of 116 cases and 115 patients were included in the review.The type of phaeohyphomycosis is dominated by the infection of skin and subcutaneous tissue.The disease was mainly induced by the damage of the skin barrier and abnormal immune function.The diagnosis was mainly based on fungal microscopy,histopathology,fungal culture and molecular identification.The treatment was mainly based on systematic antifungal treatment.Itraconazole was the most commonly used drug.Ten patients were dead in 107 patients with prognostic information,accounted for 9.35%(10/107);Mortality of the central nervous system infection was highest,75%(6/8)of the known prognostic population.Conclusion The number of cases of phaeohyphomycosis in the mainland of China has increased significantly in recent years.All health workers should raise the awareness of the disease,making early diagnosis and timely treatment,carrying out the molecular identificationin and in vitro drug sensitivity test at the same time,so as to provide more effective information for clinical treatment.