【摘要】： 足癬是皮膚癬菌侵犯足趾間、足跖、足跟、足側(cè)緣的一種常見的真菌感染性疾病,具有傳染性強(qiáng),發(fā)病率高,容易復(fù)發(fā)和再感染等特點(diǎn),對(duì)患者的生活質(zhì)量造成很大程度的影響。足癬的主要致病菌為紅色毛癬菌,其病原菌菌種構(gòu)成及分布存在地區(qū)差異,而且隨著人口流動(dòng)、環(huán)境因素變化及治療干預(yù)等,同一地區(qū)的菌種也會(huì)發(fā)生變遷。目前,關(guān)于晉城地區(qū)煤礦工人足癬的患病情況及病原學(xué)流行病學(xué)的詳細(xì)資料尚未見報(bào)道。 目的：了解井下煤礦工人足癬患病情況,確定主要致病菌及其分布情況。 方法：對(duì)2009年6月在山西省長平煤業(yè)公司王臺(tái)醫(yī)院進(jìn)行健康體檢的1078例礦井下職工進(jìn)行足癬調(diào)查,由皮膚科醫(yī)生詢問病史,進(jìn)行足部檢查,并做出臨床診斷可疑者行真菌直接鏡檢及培養(yǎng)鑒定,同時(shí)進(jìn)行足癬臨床類型的調(diào)查,填寫相關(guān)的體檢表。提取典型皮損行真菌培養(yǎng)進(jìn)行致病菌種分析。 結(jié)果：井下煤礦工人的足癬患病率為25.1%,患者各年齡組、工齡組的患病率隨年齡之增長而遞增,工齡5年以上者其患病率明顯高于5年以下者(P0.01),一線(掘進(jìn)、采煤)、二線(通風(fēng)、運(yùn)輸、機(jī)電)各工種工人的患病率無差異性(P0.05)。足癬類型以浸漬糜爛型為主,占41.3%。致病菌培養(yǎng)結(jié)果顯示紅色毛癬菌53株(60.9%),須癬毛癬菌26株(29.9%),犬小孢子菌6株(6.9%),白色念珠菌2株(2.3%)。在三種足癬類型中,角化過度型和浸漬糜爛型的致病菌主要是紅色毛癬菌,分別占54.5%和73.2%；而水皰鱗屑型的主要致病菌為須癬毛癬菌占54.2%。 結(jié)論：本次調(diào)查顯示煤礦工人的患病率為25.1%。較20年前煤礦工人33%～50%的足癬患病率有明顯下降,晉城地區(qū)煤礦工人足癬的致病菌種中優(yōu)勢(shì)致病菌為紅色毛癬菌,其次是須癬毛癬菌,在煤礦工人的三種足癬類型中,角化過度型和浸漬糜爛型的致病菌主要是紅色毛癬菌,而水皰鱗屑型的主要致病菌為須癬毛癬菌。本調(diào)查對(duì)煤礦礦工足癬的職業(yè)預(yù)防和臨床診治具有一定的參考價(jià)值。
[Abstract]:Tinea pedis is a common fungal infectious disease that infects the toes, plantar, heel and lateral margin of the foot by dermatophytes. It is characterized by strong infectivity, high incidence, easy recurrence and re-infection. It has a great impact on the quality of life of patients. The main pathogenic bacteria of tinea pedis is Trichophyton rubrum. There are regional differences in the composition and distribution of the pathogenic bacteria, and with the change of population flow, environmental factors and treatment intervention, the species of the same region will also change. At present, the detailed data on the prevalence and etiological epidemiology of tinea pedis among coal miners in Jincheng area have not been reported. Objective: to understand the prevalence of tinea pedis in underground coal miners and determine the main pathogenic bacteria and their distribution. Methods: a total of 1078 workers who underwent physical examination in Wangtai Hospital of Changping Coal Industry Company in Shanxi Province in June 2009 were investigated for tinea pedis. The dermatologist inquired about the history of the disease and examined the foot. The patients with suspicious clinical diagnosis were examined by direct mycological examination and culture, and the clinical types of tinea pedis were investigated, and the relevant physical examination forms were filled out. The typical skin lesions were isolated and cultured for the analysis of pathogenic bacteria. Results: the prevalence rate of tinea pedis in underground coal miners was 25.1%. The prevalence of tinea pedis increased with the increase of age in all age groups and working age groups. The prevalence of tinea pedis was significantly higher in those with more than 5 years of service (P0.01). There was no difference in the prevalence rate of the workers in the second line (ventilation, transportation, electromechanical) (P0.05). The type of tinea pedis was mainly impregnated and erosive, accounting for 41.3%. The results showed that 53 strains (60.9%) of Trichophyton rubrum, 26 strains (29.9%) of Trichophyton rubrum, 6 strains (6.9%) of microsporozoa canis, 2 strains (2.3%) of Candida albicans. Among the three types of tinea pedis, the major pathogens of keratosis and erosion type were Trichophyton rubrum (54.5%) and tinea versicolor (73.2%), while the major pathogenic bacteria of blister scale type were Trichophyton tubuloides (54.2%). Conclusion: the prevalence rate of coal miners is 25. 1%. Compared with 20 years ago, the prevalence of tinea pedis in coal miners was significantly lower than that 20 years ago. The dominant pathogenic bacteria of tinea pedis among coal miners in Jincheng area were Trichophyton rubrum, followed by Trichophyton rubrum, among the three types of tinea pedis of coal miners. The main pathogenic bacteria of keratosis and erosion type were Trichophyton rubrum, while the main pathogenic bacteria of blister scale type were Trichophyton tubuloides. This investigation has certain reference value for occupational prevention, clinical diagnosis and treatment of coal miners' tinea pedis.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R756

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