艾滋病患者口腔真菌感染的临床特征分析  

Clinical characteristics of oral fungal infections in AIDS patients

作　　者：刘爱良 裴壮敏 杨佑成 

机构地区：[1]山东省广饶县人民医院口腔科,山东广饶县257300

出　　处：《中华医院感染学杂志》2015年第13期3073-3075,共3页Chinese Journal of Nosocomiology

基　　金：山东省卫生厅重点基金资助项目(SW-2010B-020)

摘　　要：目的分析艾滋病(AIDS)患者口腔真菌感染的临床特征,提高临床医师对AIDS早期临床表现的认识,并进行针对性治疗以提高患者的生存质量。方法选取2010年12月-2013年12月医院治疗的82例艾滋病真菌感染患者为研究对象,分析患者临床症状、体征,对感染真菌进行培养及药敏试验,对患者进行高效抗反转录病毒联合治疗(HAART)和口腔局部抗真菌治疗,并观察疗效。结果艾滋病患者真菌感染主要临床症状是消瘦、发热、吞咽痛、咳嗽、咳痰、咽痛、口腔黏膜白斑、牙龈白斑、口腔充血、口腔糜烂等;82例患者共检出真菌82株,以假丝酵母菌属为主74株占90.24%,其中口腔假丝酵母菌属感染最多62株占75.61%,其次为泌尿道假丝酵母菌属感染12株占14.63%;真菌对氟胞嘧啶和两性霉素B的耐药率最低<3.00%。结论口腔是艾滋病真菌感染好发部位,口腔白色假丝酵母菌感染是最常见的早期征象,对非法采供血、输血、静脉吸毒或不安全性行为等特殊人群,出现难以治愈的真菌性口炎并反复发作,应及时进行人类免疫缺陷病毒抗体检测并及时治疗。OBJECTIVE To analyze the clinical features of fungal infections in HIV （AIDS） patients so as to im‐prove early awareness of AIDS by clinicians and improve life quality of patients through targeted therapy . METHODS A total of 82 cases of AIDS patients who were infected by fungi in the hospital from Dec .2010 to Dec . 2013 were chosen as study objects .The clinical symptoms and signs were analyzed and the fungi infected by them were cultured to make a drug sensitivity tests .The patients received highly active anti-retroviral therapy and oral local anti‐fungi therapy .The clinical efficacy was observed .RESULTS The main clinical symptoms of fungal infec‐tions of AIDS were weight loss ,fever ,swallowing pain ,cough ,sputum ,sore throat ,mucous membrane of mouth ,white patches on gingival ,oral hyperemia and oral erosion .Totally 82 strains of fungi were detected . Candida with 74 strains dominated the majority ,accounting for 90 .24% .And oral Candida infection had found to the most common with 62 strains ,holding 75 .61% ,followed by urinary tract Candida infection with 12 strains ,accounting for 14 .63% .Fungi had the lowest drug resistance rate to flucytosine and amphotericin B with the rate less than 3 .00% .CONCLUSION Oral cavity is the predilection site for fungi infection in AIDS patients and the oral white Candida infection is the most common signs for AIDS .Special crowd experienced illegal blood col‐lecting and supplying ,blood transfusion ,intravenous drug use and unsafe sex activity should adopt HIV antibody detection and receive therapy in time if they have appeared obstinate oral infections complicated with recurrent my‐codermatitis .

关 键 词：艾滋病 真菌 口腔感染 临床诊断 治疗 

分 类 号：R181.32[医药卫生—流行病学]