CAJ | 학술논문

目的：研究真菌性鼻窦炎的临床特点及病原菌，及其指导临床治疗的意义。方法收集2010年1月~2014年12月由首都医科大学附属北京同仁医院收治的疑似真菌性鼻窦炎患者的鼻腔组织标本315例，进行直接显微镜检查和培养鉴定，并收集患者性别、年龄、取材部位等资料。分析真菌性鼻窦炎患者性别年龄分布情况，培养阳性标本取材部位与菌群和直接镜检与培养结果。结果在315例患者中女性171例(54.29%)，男性144例(45.71%)；0~15岁患者为12例(3.81%)，>15~30岁患者为29例(9.21%)，>30~60岁患者为241例(76.51%)，>60岁患者为33例(10.47%)；315例标本有287例直接镜检阳性，207例真菌培养阳性，202例直接镜检与培养均阳性，23例直接镜检与培养均阴性；在培养阳性的207例标本中，上颌窦的标本156例(75.36%)，来源于蝶窦的标本26例(12.56%)，来源于筛窦的标本21例(10.15%)，来源于额窦的标本4例(1.93%)；真菌性鼻窦炎主要致病菌为黄曲霉菌77例(37.20%)，烟曲霉菌68例(32.85%)，尖端赛多孢子菌11例(5.31%)。结论真菌性鼻窦炎发病人群主要为青壮年，女性多于男性，发病部位主要为上颌窦，致病真菌主要为曲霉菌属。
목적：연구진균성비두염적림상특점급병원균，급기지도림상치료적의의。방법수집2010년1월~2014년12월유수도의과대학부속북경동인의원수치적의사진균성비두염환자적비강조직표본315례，진행직접현미경검사화배양감정，병수집환자성별、년령、취재부위등자료。분석진균성비두염환자성별년령분포정황，배양양성표본취재부위여균군화직접경검여배양결과。결과재315례환자중녀성171례(54.29%)，남성144례(45.71%)；0~15세환자위12례(3.81%)，>15~30세환자위29례(9.21%)，>30~60세환자위241례(76.51%)，>60세환자위33례(10.47%)；315례표본유287례직접경검양성，207례진균배양양성，202례직접경검여배양균양성，23례직접경검여배양균음성；재배양양성적207례표본중，상합두적표본156례(75.36%)，래원우접두적표본26례(12.56%)，래원우사두적표본21례(10.15%)，래원우액두적표본4례(1.93%)；진균성비두염주요치병균위황곡매균77례(37.20%)，연곡매균68례(32.85%)，첨단새다포자균11례(5.31%)。결론진균성비두염발병인군주요위청장년，녀성다우남성，발병부위주요위상합두，치병진균주요위곡매균속。
Objective To research the clinical characteristics and pathogens of fungal rhinosinusitis (FRS), and guide the clinical treatment. Methods 315 cases of nasal tissue samples were collected from patients who were admitted to Beijing Tongren Hospital and suspected fungal rhinosinusitis from January 2010 to December 2014. These cases were identified by direct microscopic examination and culture, and their genders, age, sites and other materials were collected. Results 315 patients were studied, of which 171 (54.29%) were female patients and 144 (45.71%) male .In all the patients, 12 (3.81%) were from 0 to 15 years old, followed by >15-30 years, >30-60 years, and over 60 years (9.21%, 76.51%, and 10.47%, respectively). In all the 315 samples, 287 were positive for microscopic examination, 207 were positive by culture, 202 were positive for both methodologies, 23 were negative for both methodologies.In all the 207 samples who were positive by culture, of which 156 (75.36%) samples were from maxillary sinus, followed by the sphenoidal, ethmoidal, and frontal sinuses (12.56%, 10.15% and 1.93%, respectively). Aspergillus flavus (37.20%), Aspergillus fumigatus (32.85% )and Scedosporium apiospermum (5.31% ) were the main pathogens of fungal rhinosinusitis. Conclusion The main patients of fungal rhinosinusitis are young adults, and most of them are female. The main pathological changes are maxillary sinus and main pathogens are Aspergillus.