METHODS: The medical records of 479 SS patients admitted to the Second Hospital of Shanxi Medical University from 2018 to 2020 were analysed to determine the clinical characteristics and risk factors that influence the occurrence of oral candidiasis infection in SS patients.
RESULTS: Patients with oral candidiasis were older than those without oral candidiasis (P < 0.05). Male SS patients had greater oral candidiasis rates (P < 0.05). Unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) were both shown to be adversely associated with oral Candida infections (P < 0.001). Logistic regression revealed that a low UWS was an independent risk factor for oral Candida infections in SS patients (OR: 0.004, P = 0.023). Greater WBC counts (OR: 1.22, P < 0.001), lower haemoglobin levels (OR: 0.97, P = 0.007), lower serum albumin levels (OR: 0.88, P < 0.001), lower IgG levels (OR: 0.91, P = 0.011), lower IgA levels (OR: 0.75, P = 0.011), and lower IgM levels (OR: 0.91, P = 0.015) were found in patients with oral Candida infections. Patients on immunosuppressive medications (OR: 0.32, P = 0.011), particularly rapamycin (P < 0.001), had a decreased rate of oral Candida infections.
CONCLUSIONS: Patients with oral candidiasis were older than those without oral candidiasis. Male SS patients are more likely to have oral candidiasis. Individuals with lower UWS and SWS are more susceptible to oral Candida infection. Oral Candida infections in SS patients depend on their immunological status. Rapamycin may increase the abundance of Treg cells to reduce oral Candida infection in SS patients.
方法:对2018-2020年山西医科大学第二医院收治的479例SS患者的病历资料进行分析,探讨影响SS患者口腔念珠菌感染发生的临床特征和危险因素。
结果:口腔念珠菌病患者年龄大于无口腔念珠菌病患者(P<0.05)。男性SS患者口腔念珠菌病率较高(P<0.05)。未刺激的全唾液(UWS)和刺激的全唾液(SWS)均显示与口腔念珠菌感染不利相关(P<0.001)。Logistic回归分析显示,低UWS是SS患者口腔念珠菌感染的独立危险因素(OR:0.004,P=0.023)。白细胞计数更大(OR:1.22,P<0.001),较低的血红蛋白水平(OR:0.97,P=0.007),降低血清白蛋白水平(OR:0.88,P<0.001),较低的IgG水平(OR:0.91,P=0.011),降低IgA水平(OR:0.75,P=0.011),口腔念珠菌感染患者的IgM水平较低(OR:0.91,P=0.015)。使用免疫抑制药物的患者(OR:0.32,P=0.011),特别是雷帕霉素(P<0.001),口腔念珠菌感染率降低。
结论:患有口腔念珠菌病的患者年龄大于没有口腔念珠菌病的患者。男性SS患者更有可能患有口腔念珠菌病。UWS和SWS较低的个体更容易受到口腔念珠菌感染。SS患者的口腔念珠菌感染取决于其免疫状态。雷帕霉素可能增加Treg细胞的丰度以减少SS患者口腔念珠菌感染。