中老年人义齿基托承托区口腔微生物感染研究及影响因素分析

Case-control study of microbial infection and analysis of influencing factors on stress-bearing areas of denture bases in middle-aged and elderly

目的调查中老年人义齿基托承托区可检出口腔微生物感染情况,分析与主要致病菌白假丝酵母菌感染相关的因素。方法选择2017年1—9月在杭州师范大学附属医院口腔科就诊的72例患者作为研究对象,分为2组:不戴义齿组(A组)36例和戴义齿组(B组)36例。采集唾液和菌斑培养并初步鉴定菌种,运用单因素和Logistic多因素回归分析可能与白假丝酵母菌感染相关的影响因素。结果 72例患者标本中可培养微生物206株:厌氧菌176株,其中A组82例,B组94例;白假丝酵母菌30株,其中A组8例,B组22例。B组白假丝酵母菌、黑色素普氏菌及乳杆菌构成比均显著高于A组(P<0.05)。B组变形链球菌构成比显著低于A组(P<0.05)。2组牙龈卟啉单胞菌构成比组间比较差异无统计学意义(P>0.05)。单因素分析证实了吸烟、夜间戴用义齿、义齿卫生和义齿使用年限与白假丝酵母菌检出的相关性,差异均具有统计学意义(P<0.05)。多因素Logistic回归分析提示吸烟、夜间戴用义齿、义齿卫生和义齿使用年限是影响白假丝酵母菌感染的主要因素。结论戴用义齿的中老年患者白假丝酵母菌检出例数显著高于不戴义齿中老年患者,其中夜间戴用义齿和义齿卫生是影响白假丝酵母菌感染最重要的因素,更容易引起义齿性口炎。

Objective To investigate the change of microbial component ratio in denture base bearing area of middleaged and elderly,and to analyze the factors associated with Candida albicans infection. Methods A total of 72 patients were selected from January to September in 2017. They were randomly divided into two groups： 36 elderly patients not wearing denture（ group A） and 36 patients wearing denture（ group B）. Their saliva and plaque were collected and cultured. Candida and anaerobion species were identified. Univariate and Logistic regression were used to explain factors predisposing to Candida infection. Results Among the 72 patients,there were 206 strains of microbe,among which 176 were anaerobes,including 82 in group A and 94 in group B; 30 were Candida albicans,of which 8 in group A and 22 in group B. The ratio of the two groups of Candida albicans,Bacterium melanoma and and Lactobacillus in the group B was significantly higher than that in the group A（ P〈0. 05）,and the difference between the two groups was statistically significant. The ratio of Streptococcus mutans in group B was significantly lower than that in group A,and the difference between the two groups was statistically significant（ P 〈0. 05）. There was no significant difference between the constituent groups of Porphyromonas gingivalis（ P 〉0. 05）. Single factor analysis confirmed the correlation between smoking,wear denture at night,denture hygiene,service life of denture and Candida albicans detection,and the differences were statistically significant（ P 〈0. 05）. Multi factor Logistic regression analysis showed that the main factors affecting Candida albicans infection were smoking,night wearing denture,denture hygiene and service life of denture. Conclusion The number of Candida albicans in middle-aged and elderly patients wearing dentures was significantly higher than that in elderly patients without denture. Night wearing denture and denture hygiene were the most important factors affecting Candida albicans infection,more likely to cause denture stomatitis.