系统性红斑狼疮患者合并甲真菌病、口腔念珠菌病的临床资料分析

Clinical Analysis of Onychomycosis and Oral Candidiasis in Systemic Lupus Erythematosus Patients

目的探讨分析系统性红斑狼疮(SLE)患者合并甲真菌病、口腔念珠菌病的情况及特点。方法观察176例SLE患者的甲真菌病及口腔念珠菌病的危险因素及其致病真菌构成情况。结果 176例SLE患者中,104例合并真菌感染。甲真菌病61例(34.66%),口腔念珠菌病69例(39.20%),其中二者同时发生26例(14.77%)。甲真菌病的主要病原体为红色毛癣菌,临床类型主要为远端侧位甲下型(52.46%)。口腔念珠菌病主要病原体为白念珠菌。甲真菌病的患病率随着SLE病程延长而增加。口腔念珠菌病的患病率受泼尼松每日用量、接受甲强龙冲击治疗、使用广谱抗生素的影响。使用免疫抑制剂及病情严重程度对二者的发生均有影响。结论 SLE易发生甲真菌病和口腔念珠菌病,要早期检查并关注存在危险因素患者的甲及口腔黏膜变化。

Objective To investigate the prevalence of onychomycosis and oral candidiasis in systemic lupus erythematosus （SLE） patients. Methods Incidence of onychomycosis and oral candidasis were observed in 176 SLE patients. Constituent ratio of the pathogenic fungi and the risk factors of the two mycoses were also included. Results One hundred and four SLE patients had concomitant mycoses. Sixty-one were onychomycosis （34.66%）, 69 oral candidiasis （39.20%）, 26 with both mycoses. Trichophyton rubrum and Candida albicans were the major pathogens of onychomycosis and oral candidiasis, respectively. Onychomycosis was correlated with the duration of SLE, immunosuppressive drug use, and severity of SLE. While oral candidiasis was correlated with prednisone dose, methylprednisolone pulse therapy, and broad-spectrum antibiotics. Nail and oral changes should be noted early in those SLE patients with risk factors, immunosuppressive drug use, and severity of SLE. Conclusion SLE patient is susceptible to onychomycosis and oral candidiasis. Nail and oral changes should be noted early in those SLE patients with risk factors.