吴红梅 陆茂 欧美 罗媛元

[摘要] 目的 检测特应性皮炎（AD）患者皮肤马拉色菌菌量，探讨其与病情严重程度的相关性。 方法 选取成都医学院第一附属医院2017年4～9月就诊的轻中重度AD患者各20例，采集其面部、上肢皮损区和非皮损区以及20例健康对照者相应区域的皮肤鳞屑标本，采用真菌荧光染色法在高倍镜下记录马拉色菌的密度，并分析马拉色菌密度与病情严重程度的相关性。 结果 轻中重度AD患者面部皮损区、非皮损区马拉色菌密度均明显高于上肢皮损区、非皮损区（P < 0.05），轻中重度AD患者各部位马拉色菌密度均明显高于健康对照者相应区域（P < 0.05），AD患者各部位马拉色菌密度与病情严重程度均无相关性（P > 0.05）。 结论 AD患者皮肤马拉色菌菌量与部位有关，与病情严重程度无关。

[关键词] 特应性皮炎；马拉色菌；荧光染色法；病情严重程度

[中图分类号] R758 [文献标识码] A [文章编号] 1673-7210（2018）08（b）-0096-04

[Abstract] Objective To detect the amount of Malassezia in the skin of patients with atopic dermatitis （AD）， and explore its correlation with the disease severity. Methods 20 mild， 20 moderate and 20 severe AD patients were selected from the First Affiliated Hospital of Chengdu Medical College from April to September 2017. Skin scales were collected as samples from the lesion and non lesion areas on the face and upper limb of AD patients as well as the corresponding areas of 20 healthy control subjects. The density of Malassezia was recorded at high magnification by fluorescent staining method. Then the correlation between the density of Malassezia and the disease severity was analyzed. Results The density of Malassezia in the lesion and non lesion areas on the face of the mild， moderate and severe AD patients was significantly higher than those of the upper limbs （P < 0.05）. The density of Malassezia in each skin area of mild， moderate and severe AD patients was significantly higher than that of healthy control subjects （P < 0.05）. The density of Malassezia in each skin area of AD patients was not correlated with the disease severity （P > 0.05）. Conclusion The amount of Malassezia in the skin of AD patients is related to the site， but not to the disease severity.

[Key words] Atopic dermatitis； Malassezia； Fluorescent staining method； Disease severity

特應性皮炎（atopic dermatitis，AD）是一种临床常见的复发性、瘙痒性、炎症性皮肤病，其病因和发病机制尚不清楚，可能是遗传因素、免疫因素、有缺陷的皮肤屏障功能、环境因素、感染因素等共同作用的结果。与感染因素有关的微生物主要有金黄色葡萄球菌，其次是真菌（包括马拉色菌及念珠菌等）[1-2]。目前国外有关马拉色菌在AD患者皮肤定植情况的报道较多，但检测结果差异较大，可能与种族、地区及检测方法有关[3-4]，而国内相关研究报道很少。本研究采用真菌荧光染色法检测AD患者面部、上肢皮损区和非皮损区马拉色菌菌量，并分析其与病情严重程度的关系，现报道如下：

1 资料与方法

1.1 一般资料

选取成都医学院第一附属医院（以下简称“我院”）2017年4～9月就诊的轻中重度AD患者各20例，病情严重程度采用湿疹面积及严重度指数评分法：<7分为轻度，7～21分为中度，>21分为重度[5]。……