225例甲真菌病临床特征及其预后影响因素研究
Clinical characteristics of 225 cases of onychomycosis and analysis of influencing factors of its prognosis
黄鑫源 1李燕 2谢玲 3尤聪 3李龙年 3曾招林3
作者信息
- 1. 赣南医科大学第一临床医学院,江西 赣州 341000
- 2. 九江市妇幼保健院,江西 九江 332000
- 3. 赣南医科大学第一附属医院皮肤性病科 国家皮肤与免疫性疾病临床研究中心分中心建设单位,江西 赣州 341000
- 折叠
摘要
目的:了解甲真菌病患者的临床特征及影响甲真菌病临床疗效的因素.方法:回顾性分析赣南医科大学第一附属医院2022年1月至2023年12月225例于门诊就诊的甲真菌病患者的一般资料,采用卡方检验、Fisher确切概率法及多因素逐步Logistic回归分析影响疗效的相关因素.结果:225例患者中男94例,女131例,年龄6～89岁,89例并发手足癣(39.56%),最常累及的部位为趾甲(128例,55.56%),最常见的临床分型为远端侧位甲下型(110例,48.89%);单因素分析结果显示,年龄、临床类型、合并糖尿病、合并手足癣、使用免疫抑制剂、甲外伤史均会影响甲真菌病的临床治疗有效率,差异有统计学意义(P＜0.05);多因素逐步Logistic回归分析结果显示,合并手足癣(OR=0.455,95%CI:0.241～0.856,P=0.015)、合并糖尿病(OR=0.173,95%CI:0.050～0.596,P=0.005)、使用免疫抑制剂(OR=0.141,95%CI:0.039～0.502,P=0.002)均可降低甲真菌病的临床疗效,而年龄、临床类型、甲外伤史与甲真菌病临床疗效无明显相关.出现药物不良反应共4例,其中无明显不适症状的肝酶指标升高3例,甲褐色色素沉着1例.结论:甲真菌病合并糖尿病、合并手足癣、使用免疫抑制剂均会影响系统性使用伊曲康唑治疗甲真菌病的临床疗效,治疗前应对每例患者进行预后评估,制定合理的治疗方案.
Abstract
Objective:To understand the patients'characteristics of onychomycosis in The First Affiliated Hospital of Gannan Medical University and the factors affecting the curative effects of onychomycosis.Methods:The general data,clinical features,concomitant diseases and curative effects of 225 patients with onychomycosis diagnosed in the outpatient department of The First Affiliated Hospital of Gannan Medical University from January 2022 to June 2022 were analyzed by chi-square test,Fisher's exact test and binomial logistic regression analysis.Results:Among the 225 patients,94 were male and 131 female,aged 6 to 89 years,89 had concomitant tinea pedis(39.56%),the most common site involved was the toenail(128 cases,55.56%),the most common clinical typology was the distal lateral subnail type(110 cases,48.89%);The results of the univariate analysis show that,age,clinical type,diabetes mellitus,hand and foot fungus,use of immunosuppressants,history of external injury would affect the clinical treatment efficacy of onycho-mycosis,with statistical significance(P＜0.05).Multiple-stepwise logistic regression analysis.showed,concomitant tinea cruris(OR=0.455,95%CI:0.241-0.856,P＜0.05),concomitant diabetes mellitus(OR=0.173,95%CI:0.050-0.596,P＜0.05)and use of immunosuppressants(OR=0.141,95%CI:0.039-0.502,P＜0.05)reduced the clinical outcome of onychomycosis.There was no significant association between clinical type,age and sex and clinical outcome of onycho-mycosis.There were 4 cases of drug zdverse reaction,including 3 with elevated liver enzymes with no obvious discomfort symptoms,and 1 with simplified brown nails.Conclusion:There are factors that influence efficacy,including comorbidities,include diabetes and tinea pedis,and use immunosuppressant.Each onychomycosis patient should be assessed before choosing a treatment method and formulate a reasonable treatment plan.
关键词
甲真菌病/临床特征/疗效/影响因素/回顾性分析Key words
Onychomycosis/Clinical features/Efficacy/Influencing factors/Retrospective analysis引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据