湿疹和特应性皮炎皮损处细菌定植情况及药物联合治疗的分析.docVIP

湿疹和特应性皮炎皮损处细菌定植情况 及药物联合治疗的分析 弓娟琴林麟郝飞 陈艳 曾凡钦李伯有毕志刚 张美华 易东 赵辨 【摘要】 目的探讨湿疹和特应性皮炎(AD)皮损处金黄色葡萄球菌(金葡菌)及其他细菌的定植情 况．评价抗菌药物与糖皮质激素联合用药的疗效。方法采用多中心、随机、双盲试验，在筛选日及治疗 后第7、14和28天对皮损评分，并在皮损和非皮损处分离细菌。试验组外用抗菌药物和糖皮质激素，对照 组外用基质和糖皮质激素。结果共人选患者327例。湿疹208例，AD“9例。湿疹皮损处细菌的阳性 率为70．19％，金葡菌占47．26％；非皮损部位细菌阳性率为32．69％，金葡菌占27．94％。AD皮损处细菌阳 性率为74．79％，金葡菌占79．78％；非皮损部位细菌阳性率为34．45％，金葡菌占80．49％。湿疹和AD皮损 部位金葡菌的定植量均高于非皮损部位(P0．01。P0．05)，细菌的定植量与皮损的严重程度呈正相关。 两组患者治疗后总体疗效无明显差异(P0．05)，但湿疹临床症状评分指数8分者及AD评分指数7 分者，在治疗的第7天．试验组与对照组的症状评分指数改善率存在显著差异(P0．05)，在治疗的第14 天和第28天，两组差异均无显著性(P0．05)。结论湿疹和AD患者皮损部位细菌的检出率和金葡菌 的带菌率均明显增高。说明金葡菌与湿疹皮炎的关系密切，早期联用抗菌药物可提高疗效。 【关键词】湿疹；皮炎，特应性；葡萄球菌，金黄色；临床对照试验 印^y如c—cc翻s 4“您珊ColoIli髓tion in Ec髓ma and Atopic De珊atitis蛐d Them呻ul她e邱∞t of Combined Topical Treatment G0ⅣG衄嘲in：￡州￡沁肌0 Fe0 c日EⅣy叭zEⅣG‰·q汛L，舶一yo％ Bl孤0蛐昏zHANG Met-h崛YI Dong’ZHAO B汛’lnst讧姚《Dermmokgy，Pek魄U如n Me如文Col一 如即CAf聊se Ac诎m’，o厂肘j批以Sc如船es，Ⅳc耐i醒210042，China 【Abstmct】 objec娃v铭 T0抽ye8figate出e c010nization features of脚b‰Dcc螂倒形嬲(s似陀w) in the skin lesions of eczema and atopic dennatitis(AD)，and to evaluate the therapeutic eⅡbct of combination toDical treatment with mupirocin and hydrocortisone butymte．Me缅ods A multicentre。double-blind randomi． zed trial was conducted．卟e SCORAD was evaluated on day l，7，14 and 28．Swabs forbacterialisolation were taken from the le8ional skin and non．1esional skin． A combination topical山erapy with mupirocin oint． ment and hvdmcortisone butvrate ointment was used in treatment肿up’with vehicle ointment and hydmcorti． sone butvrate ointment as a contr01．R姻llIts Three hundred arld twentv seven Datients were enrolled in the study，including 208 patients with eczema and l 19 patients with 8topic de册atitis．Bacteria weI_e isolated fbm 70．19％of lesional skin and 32．69％of non．1esional skin of patients witIl eczema，in which S．口Mre淞account． ed for 47．26％and 27．94％resDectively． Bacteria were isolated f而m 74．79％0f tlIe lesional skin蛐d 34．45％ of non．1esional skin of Datients with atopic de咖atitis，in which S．帆re淞accounted and 79．78％or 80