皮肤浅部真菌患者KOH镜检结果及细胞免疫相关指标对真菌感染和定植的鉴别价值分析  

Analysis of differential value of KOH microscopic examination results and cellular immunity related indexes on fungal infection and colonization in superficial skin fungal patients

作　　者：林宁宁[1] 杨正生[1] 林瑞静 张路方 杨会君[1] LIN Ning-ning;YANG Zheng-sheng;LIN Rui-jing(Department of Dermatology of Qinhuangdao First Hospital,Qinhuangdao 066000,China;Department of Physical Examination of Traditional Chinese Medicine Hospital of Luanping County,Luanping 068250,China)

机构地区：[1]秦皇岛市第一医院皮肤科,河北秦皇岛066000 [2]河北滦平县中医院体检科,河北滦平068250

出　　处：《中国实验诊断学》2021年第6期796-800,共5页Chinese Journal of Laboratory Diagnosis

基　　金：秦皇岛市科学技术研究与发展计划(201805A047)。

摘　　要：目的分析皮肤浅部真菌患者氢氧化钾溶液(KOH)镜检结果及细胞免疫相关指标对真菌感染和定植的鉴别价值。方法选取2019年1月-2020年1月医院收治的皮肤浅表真菌感染患者135例作为研究对象,取所有研究对象待检样本,行KOH镜检,分析KOH对各样本的阳性检出情况。使用美国BectonDickinso公司流式细胞仪检测细胞免疫相关指标CD3+、CD4+、CD8+水平,并计算CD4+/CD8+比值,分析细胞免疫相关指标CD3+、CD4+、CD8+水平及CD4+/CD8+比值对细胞感染、定植的鉴别价值。进一步采用ROC曲线分析细胞免疫相关指标CD3+、CD4+、CD8+水平及CD4+/CD8+比值对细菌感染和定植的鉴别价值。结果 135例样本中KOH镜检显示105例阳性,阳性检出率为77.78%(105/135)。其中体癣样本阳性检出率为85.71%(24/28),足癣样本阳性检出率为79.17%(19/24),甲癣样本阳性检出率为81.48%(22/27),花斑糠疹样本阳性检出率为65.52%(19/29),头癣样本阳性检出率为77.78%(21/27)。与真菌定植组相比,真菌感染组患者CD3+、CD4+、CD4+/CD8+降低,CD8+升高,差异具有统计学意义(P<0.05)。与CD3+、CD4+、CD8+、CD4+/CD8+单独鉴别相比,4项联合对皮肤浅表细菌感染和定植的鉴别价值最为理想(P<0.05)。结论 KOH镜检对皮肤浅部真菌的阳性检出率高于60%,且CD3+、CD4+、CD4+/CD8+在真菌感染中降低,CD8+在真菌感染中升高,可用于真菌感染和定植的鉴别。Objective Analysis of the results of microscopic examination of potassium hydroxide solution(KOH)and the differential value of cellular immune related indexes on fungal infection and colonization in superficial fungal patients.Methods 135 patients with superficial fungal infection in our hospital from January 2019 to January 2020 were selected as the research objects.All the samples to be tested were taken for KOH microscopic examination,and the positive detection of KOH on each sample was analyzed.The levels of CD3+,CD4+,CD8+ and CD4+/CD8+were measured by flow cytometry of Becton dickinso company in the United States,and the ratio of CD4+/CD8+ was calculated to analyze the differential value of CD3+,CD4+,CD8+ and CD4 +/CD8+ratio in cell infection and colonization.ROC curve was used to analyze the differential value of CD3+,CD4+,CD8+and CD4+/CD8+ratio in bacterial infection and colonization.Results among 135 samples,105 cases were positive by KOH microscopy,and the positive detection rate was 77.78%(105/135).The positive detection rate of tinea corporis was 85.71%(24/28),tinea pedis was 79.17%(19/24),onychomycosis was 81.48%(22/27),pityriasis versicolor was 65.52%(19/29),tinea capitis was77.78%(21/27).Compared with fungal colonization group,CD3+,CD4+,CD4+/CD8+ in fungal infection group were lower,and CD8+ was higher,the difference was statistically significant(P<0.05).Compared with CD3+,CD4+,CD8+,CD4+/CD8+ alone,the combination of the four was the best in the identification of superficial bacterial infection and colonization(P<0.05).Conclusion The positive rate of KOH microscopic examination was higher than60%.CD3+,CD4+,CD4+/CD8+decreased in fungal infection,and CD8+increased in fungal infection,which can be used to identify fungal infection and colonization.

关 键 词：皮肤浅部真菌 氢氧化钾溶液镜检 细胞免疫相关指标 真菌感染 真菌定植 

分 类 号：R379[医药卫生—病原生物学]