真菌性外耳道炎的病原学特征及治疗效果  

Etiological characteristics of fungal otitis externa and therapeutic effect

作　　者：吴丽华[1] 蒋刈[1] 陈娟[1] 黄少鹏[1] 刘庆华[1] 李瑞玉[1] 叶青[1] WU Li-hua;JIANG Yi;CHEN Juan;HUANG Shao-peng;LIU Qing-hua;LI Rui-yu;YE Qing(Provincial Clinical Medical College of Fujian Medical University(Fujian Provincial Hospital),Fuzhou,Fujian 350001,China)

机构地区：[1]福建医科大学省立临床医学院(福建省立医院)耳鼻咽喉头颈外科

出　　处：《中华医院感染学杂志》2019年第21期3288-3292,共5页Chinese Journal of Nosocomiology

基　　金：福建省自然科学基金资助项目(2015J02483)

摘　　要：目的分析真菌性外耳道炎的病原学特征,探讨氟康唑联合硝酸咪康唑的治疗效果。方法收集福建医科大学省立临床医学院115例(124耳)真菌性外耳道炎患者,统计其病原菌分布情况。按照随机数表法分为研究组(n=56,氟康唑联合硝酸咪康唑)和对照组(n=59,硝酸咪康唑),对比两组治疗效果、血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平及不良反应发生情况。结果115例真菌性外耳道炎患者中≥61岁组占比最高,其次是21岁~30岁组和≤20岁组。男性占比高于女性。115例患者124耳真菌性外耳道炎中曲霉菌属构成比最高,占65.32%。研究组总有效率高于对照组(P<0.05)。研究组治疗后血清IL-2、IL-6、TNF-α水平低于对照组(P<0.05)。两组不良反应发生率对比无差异。结论真菌性外耳道炎中的病原菌曲霉菌属占比最高,应用氟康唑联合硝酸咪康唑治疗疗效明显,能够降低患者的血清炎症因子水平,安全性较好。OBJECTIVE To investigate the etiological characteristics of fungal otitis externa and explore the effect of fluconazole combined with miconazole nitrate.METHODS A total of 115 patients with fungal otitis externa(124 ears)who were treated in Provincial Clinical Medical College of Fujian Medical University were enrolled in the study and randomly divided into the study group with 56 cases and the control group with 59 cases,the study group was treated with fluconazole combined with miconazole nitrate,and the control group was treated with miconazole nitrate.The distribution of pathogens was statistically analyzed.The curative effect,levels of serum interleukin-2(IL-2),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and incidence of adverse reactions were observed and compared between the two groups.RESULTS Among the 115 patients with fungal otitis externa,the patients who were no less than 61 years of age were dominant,followed by the patients aged between 21 and 30 years old and the patients aged no more than 20 years old;the proportion of the male patients was remarkably higher than that of the female patients.Aspergillus was the predominant pathogen isolated from the 115 patients with fungal otitis externa(124 ears),accounting for 65.32%.The total effective rate of the study group was significantly higher than that of the control group(P<0.05).The levels of serum IL-2,IL-6 and TNF-αof the study group were significantly lower than those of the control group after the treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.CONCLUSION Aspergillus is dominant among the pathogens isolated from the patients with fungal otitis externa.Fluconazole combined with miconazole nitrate can achieve remarkable curative effect and reduce the levels of serum inflammatory factors,with the safety high.

关 键 词：真菌性外耳道炎 病原学 氟康唑 硝酸咪康唑 炎症因子 

分 类 号：R764.1[医药卫生—耳鼻咽喉科]