中国大陆马尔尼菲青霉病的临床表现及流行病学特征的系统评价  

Penicillium marneffei infection in the mainland of China:a systematic review on its clinical and epidemiological features

作　　者：赵国庆[1] 冉玉平[1] 向耘[1] 

机构地区：[1]四川大学华西医院皮肤性病科,成都610041

出　　处：《中国真菌学杂志》2007年第2期68-72,共5页Chinese Journal of Mycology

基　　金：国家自然科学基金资助项目(30570095)

摘　　要：目的了解马尔尼菲青霉病在我国大陆地区的临床及流行病学特征。方法应用计算机和人工检索我国大陆地区1985～2006年间公开报道的有关马尔尼菲青霉病的文献,归纳其临床和流行病学特征。结果共纳入46篇文献,涉及138例马尔尼菲青霉病患者,其中人类免疫缺陷病毒(HIV)阳性者98例(71.0%),发病呈逐年上升趋势,男性发病远多于女性(3.6∶1)。临床表现中发热132例(95.7%);有网状内皮系统体征(肝、脾、淋巴结肿大)111例(80.4%);贫血104例(75.3%);皮疹100例(72.5%);肺部病变(肺部结核样阴影、间质性肺炎、胸膜炎、胸腔积液、肺纹理增粗等)91例(65.9%)。66例(47.8%)死亡。结论我国大陆地区的马尔尼菲青霉病发病逐年上升,患者HIV阳性率高,临床表现主要为发热、贫血、肝脾或淋巴结肿大、肺部病变、皮疹等。Objective To understand epidemiological and clinical features of penicillosis marneffei in the mainland of China. Methods We searched all of documents related to Penicillium marneffei infection that published in China since 1985 to 2006 by computer and manually, and systematically reviewed the epidemiological and clinical features of the disease. Results One hundred and thirty-eight cases from 46 articles were brought into this study. The incidence of penicillosis marneffei was rising year by year in the mainland of China since 1989. The male was predominant compared with the female （ ratio 3.6 ： 1 ）. Eighty-nine patients （71% ） accompanied with human immunodeficiency virus （HIV） antibodies-positive. Infection rate of Penicillium marneffei in HIV- positive patients arrived at 12.3% in several city of Guangxi. One hundred and thirty-two patients （95.7%） had fever. One hundred and eleven patients （ 80.4% ） presented hepatomegaly, splenomegaly or enlargement of lymph nodes. Anaemia occurred in 104 patients （75.3%）. One hundred patients （72.5%） had skin lesions. Lung involvment happened to 91 patients （65.9%）. Sixty-six patients （47.8%） died in the end. Conclusion Our results suggest that infection rate of Penicillium marneffei trend to rise up in the mainland of China, and HIV-positive patients have high infection rate. Clinical features of the disease mostly include fever, anemia, skin lesions, lung involvment, hepatomegaly or splenomegaly or enlargement of lymph nodes.

关 键 词：马尔尼菲青霉病 系统评价 中国大陆 

分 类 号：R519.9[医药卫生—内科学]