鼻咽癌放疗期患者的口腔反应及口腔念珠菌负荷状况和生物分型  

STUDY OF ORAL REACTION AND CANDIDAL COLONIZATION STATUS AND BIOTYP-ING OF CANDIDA IN PATIENTS OF NASOPHARYNGEAL CARCINOMA DURING RADI-OTHERAPY

作　　者：牙祖科[1] 黄光武[2] 陶人川[1] 邓华颉[1] 

机构地区：[1]广西医科大学口腔医学院,南宁530021 [2]广西医科大学第一附属医院耳鼻咽喉科

出　　处：《广西医科大学学报》2005年第3期329-331,共3页Journal of Guangxi Medical University

基　　金：国家自然科学基金(No.30160087);广西青年科学基金(No.桂科青0144029)资助

摘　　要：目的:探讨鼻咽癌(NPC)放疗期患者口腔反应及念珠菌负荷状况及生物分型.方法:同期观察NPC放疗期患者48例(实验组)和健康对照者42例(对照组)的口腔反应,并采取漱口法进行口腔念珠菌的定量检测,利用革兰染色法、厚壁孢子生成实验、CHROMagar显色培养和API 20 CAUX鉴定系统对分离株进行生物型鉴定.结果:实验组中有30例主诉口干、疼痛,其中10例伴有味觉障碍; 8例有放射性口炎;7例为口腔念珠菌病,与对照组比较差异有统计学意义(P<0.05或P<0.01);实验组口腔念珠菌的检出率为50.00%,高负荷检出均来自有口干主诉的患者,而对照组仅为16.67%,负荷均低于500 CFU/ml,两组比较差异有统计学意义(P=0.001,OR值=3.000,95% CI 1.44～6.24); 24个分离株中白色念珠菌15株,近平滑念珠菌2株,高里念珠菌2株,法氏念珠菌2株,其它3株.结论:NPC放疗期患者口腔健康状况受损,主要表现为口干和放射性口炎,口腔念珠菌病发生率增高.口腔念珠菌的检出率增加,除白色念珠菌外,其它菌型亦可能成为NPC放疗患者口腔念珠菌的病原菌.Objective：To investigate the status of oral health and Candidal colonization and the biotyping of Candida in patients of Nasopharyngeal carcinoma （NPC） undergoing radiotherapy. Methods：The studied population comprised of 48 NPC patients and 42 healthy controls. Oral rinse technique was used to detect the candidal carriage. The isolates were identified using multiple measures such as gram staining reaction, chlamydospor, pseudohyphal and hyphal production test, Chromagar Candida test and API 20 CAUX yeast identification system. Result ：Oral response occurred to 30 out of 48 NPC cases during radiotherapy, 8 out of 48 NPC cases were confirmed to have radiation-induced mucotitis, 7 out of 48 NPC cases developed oral candidiasis ,compared to healthy controls,which showed significant high prevalence and high load of candida species in NPC patients during radiotherapy （ P 〈 0.05 or P 〈 0.01）. In NPC group, Candida was found in 24 out of 48 NPC cases and 7 out of 42 of controls（ P =0. 001,OR=3. 000, 95%confidence interval 1.44-6.44）; 24 stains of candida were isolated from the 48 NPC cases, including 15 srains of candida albicans, 2 srains of Candida parapsilosis, 2 srains of C. guilliermondii, 2 srains of Candida famata and 3 srains of others. 5 out of 7 isolated from healthy controls were identified as Candida albicans instead. Conclusion：Radiotherapy can cause the change of the oral health status of the NPC patients, and the incidence of oral candidiasis was higher than the health controls; The candida load increased in NPC cases, and Candida albicans was the major candidal isolate from NPC patients undergoing radiotherapy. In addition, other biotyping of Candida could be easier to be the pathogens in oral cavity.

关 键 词：口腔 念珠菌属 鼻咽癌 放疗 

分 类 号：R781.5[医药卫生—口腔医学]