口腔黏膜病患者口腔念珠菌感染情况的分析

Analysis of oral candida infection in patients with oral mucosal diseases

目的 分析了解口腔黏膜病患者感染白念珠菌的情况。方法 收集2019年就诊于口腔黏膜科并进行白念珠菌培养的2 289例患者,收集其基本信息、临床资料及实验室检查情况。按年龄分组:0~16岁(1组,38例),17~29岁(2组,181例),30~39岁(3组,274例),40~49岁(4组,325例),50~59岁(5组,535例),60~69岁(6组,540例),70岁及以上(7组,396例)。结果 白念珠菌总感染率为30.6%,且女性患者感染率高于男性(33.1%vs.25.1%,P<0.05)。随着年龄的增长,白念珠菌感染率总体是上升的,且第6、7组感染率明显高于第2、3、4、5组(P<0.05)。除了口腔念珠菌病本身,唇舌疾病及口腔斑纹类疾病中最容易检测出白念珠菌,且白念珠菌的阳性检出与唇舌疾病、干燥综合征、口腔斑纹类疾病等相关。在同时进行白念珠菌培养及真菌镜检且白念珠菌培养阳性的患者中,真菌镜检阳性为50例,阳性率为35.5%。对白念珠菌培养阳性患者进行制霉素片及2%~3%碳酸氢钠溶液的局部治疗,其药物有效率为81.36%。结论 口腔念珠菌病更容易发生于60岁以上老年女性;且与系统性疾病、口腔斑纹类疾病相关。制霉素片联合2%~3%碳酸氢钠溶液局部治疗口腔念珠菌病效果尚可。

Objective To analyse Candida albicans infection in patients with oral mucosal diseases. Methods A total of 2 289 patients who visited the Department of Oral Mucosal Disease in 2019 and underwent Candida albicans culture were collected. Clinical and laboratory data were collected on each patient. They were grouped by age: 0-16 years old(Group 1, 38 patients), 17-29 years old(Group 2, 181 patients), 30-39 years old(Group 3, 274 patients), 40-49 years old(Group 4, 325 patients), 50-59 years old(Group 5, 535 patients), 60-69 years old(Group 6, 540 patients), 70 years and older(Group 7, 396 patients). Results The total infection rate of Candida albicans was 30.6%, and the infection rate of female patients was higher than that of males(33.1% vs. 25.1%, P<0.05). The overall rate of Candida albicans infection increased with age, and the infection rate in Group 6 and 7 was significantly higher than that in Group 2, 3, 4, and 5(P<0.05). In addition to oral candidiasis itself, Candida albicans was most easily detected in labial and lingual diseases and oral marking diseases, and the positive detection of Candida albicans was associated with labial and lingual diseases, Sjogren′s syndrome, and oral marking diseases, etc. Among patients who had both candida albicans culture and fungal microscopy, the fungal microscopy was positive in 50 patients who had a positive Candida albicans culture and the positive rate was 35.5%. The topical treatment of patients with positive culture of Candida albicans, using nystatin tablets and 2%-3% sodium bicarbonate solution, resulted in a drug response rate of 81.36%. Conclusion Oral candidiasis is more likely to occur in elderly women over 60, and is associated with systemic diseases and oral marking diseases. The efficacy of topical treatment of oral candidiasis using the combination of nystatin tablets and 2%-3% sodium bicarbonate solution is acceptable.