头颈部癌放疗患者口腔念珠菌定植特征及分析

上海口腔医学 ›› 2014, Vol. 23 ›› Issue (5): 605-608.

头颈部癌放疗患者口腔念珠菌定植特征及分析

张媛媛, 李爱芹, 王宁宁, 刘莉娜, 崔继丽

郑州大学口腔医学院口腔黏膜病科,河南郑州 450052

收稿日期:2013-12-13 修回日期:2014-01-10 出版日期:2014-10-20 发布日期:2015-02-04
通讯作者: 张媛媛,Tel:0371-66912883,E-mail：zhyy143@126.com
作者简介:张媛媛(1978-),女,博士,副主任医师

Oral candida species distribution in patients receiving radiotherapy for head and neck cancer

ZHANG Yuan-yuan, LI Ai-qin, WANG Ning-ning, LIU Li-na, CUI Ji-li

Department of Oral Medicine, School of Stomatology, Zhengzhou University. Zhengzhou 450052, Henan Province, China

Received:2013-12-13 Revised:2014-01-10 Online:2014-10-20 Published:2015-02-04

摘要/Abstract

摘要： 目的了解头颈部癌(head and neck cancer,HNC)接受放射治疗患者临床分离口腔念珠菌的菌株定植特征,为临床防治方案的制定提供依据。方法随机抽取60例HNC患者,于放疗前、放疗期间、放疗结束采用口腔含漱法取样,CHROMagar显色培养基、API 20C AUX 酵母菌鉴定系统进行分离培养鉴定,比较2组念珠菌的检出率和不同念珠菌种的检出量的差异。采用SPSS 17.0软件包进行统计学处理。结果 60例HNC放疗患者中,54例出现口干和吞咽困难,50例产生放射性口腔黏膜炎（radiation-induced oral mucositis,RIOM）,18例感染口腔念珠菌病;60例HNC放疗患者放疗期间和放疗结束口腔念珠菌的检出率分别为56.7%和63.3%,较放疗前（26.7%）明显升高,具有显著差异(χ²=18.320,P<0.001);54例临床分离株以白念菌为主（n=42）,其次是近平滑念珠菌（n=6）、热带念珠菌（n=4）和光滑念珠菌（n=2）;放疗患者口腔念珠菌致病菌的检出率量为30%,定植菌占46.7%。结论 HNC放疗患者口腔念珠菌的定植率明显升高,念珠菌感染可能是RIOM发生的重要原因。

关键词: 头颈部癌, 放射治疗, 口腔黏膜炎, 口腔念珠菌

Abstract: PURPOSE: To investigate the distribution of oral candida species in head and neck cancer (HNC) patients treated with radiation therapy, and provide the basis for planning of clinical preventive measures. METHODS: Saliva was sampled from 60 HNC patients before, during and after radiation. Concomitantly, 60 healthy individuals whose age and sex matched that of the patient group were selected as control group. Oral candida carriages were quantitatively detected and the different candida species were identified by multiple measures such as CHROMagar candida culture medium and API 20C AUX yeast identification system. Then the differences between the two groups in terms of the candida detection rate and the distribution of each species of candida were analyzed with SPSS 17.0 software package. RESULTS: Xerostomia and dysphagia was found in 54 HNC patients during radiotherapy, radiation-induced oral mucotitis(RIOM) was found in 50 HNC patients,and oral candidiasis was found in 18 HNC patients; In radiation group, the detection rate of candida colonization during radiation was 56.7%, 63.3% postradiation, which showed significant differences compared with pre-radiation (χ²=18.320,P<0.001 ); Among the 54 identified clinical isolates, candida albicans (n=42) was the most frequent, followed by candida parapsilosis (n=6), candida tropicalis (n=4) and candida glabrata (n=2). In radiation group, the oral candida pathogens detection rate was 30%, and candida colonization was 46.7%. CONCLUSIONS: The oral candida colonization rate was significantly higher in HNC patients after radiotherapy, which indicated that the candida infection may be closely related to RIOM.

Key words: Head and neck cancer, Radiotherapy, Oral mucositis, Oral candida

张媛媛, 李爱芹, 王宁宁, 刘莉娜, 崔继丽. 头颈部癌放疗患者口腔念珠菌定植特征及分析[J]. 上海口腔医学, 2014, 23(5): 605-608.

ZHANG Yuan-yuan, LI Ai-qin, WANG Ning-ning, LIU Li-na, CUI Ji-li. Oral candida species distribution in patients receiving radiotherapy for head and neck cancer[J]. Shanghai Journal of Stomatology, 2014, 23(5): 605-608.

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