口腔白念珠菌基因型分析及临床意义

目的 研究不同口腔黏膜病白念珠菌分离株的基因型特点。方法 采用计算机系统辅助随机扩增多态性DNA(RAPD)分析，对健康人和黏膜病患者口腔的38株念珠菌菌株进行基因分型。结果 38株菌株中36株被鉴定为白念菌，其余2株为热带念珠菌。白念菌RAPD分析共出现21种RAPD带型。扁平苔藓组与口腔念珠菌病组间白念致病菌RAPD指纹图无明显相似性。结论 不同基因型白念菌的定植可能与口腔黏膜病的种类有关。     

萎缩糜烂型口腔扁平苔藓患者不同基因型白色念珠菌的药敏研究

目的:对萎缩糜烂型口腔扁平苔藓不同基因型白色念珠菌进行药物敏感性研究,为临床有效治疗萎缩糜烂型口腔扁平苔藓白色念珠菌感染提供依据。方法:采用聚合酶链反应(PCR)对101株萎缩糜烂型口腔扁平苔藓白色念珠菌进行基因分型,然后采用微量稀释法测定白色念珠菌不同基因型对4种临床常用抗真菌药物的敏感性。采用SPSS16.0软件包对数据进行χ2检验。结果:101株白色念珠菌中,A型39株,B型17株,C型45株。A型对5-氟胞嘧啶耐药率显著高于B、C型(P<0.05);B型对氟康唑耐药率显著高于A型(P<0.05);C型对伊曲康唑耐药率显著高于A型(P<0.05);B、C型均未出现制霉菌素耐药株,A、B、C型对制霉菌素的耐药率无显著性差异(P>0.05)。结论:萎缩糜烂型口腔扁平苔藓白色念珠菌不同基因型对抗真菌药物的耐药性有差异,治疗时应根据基因分型和药敏试验结果合理选用抗真菌药物。治疗萎缩糜烂型口腔扁平苔藓伴发白色念珠菌感染时,制霉菌素的临床价值应该引起充分重视。     

口腔扁平苔藓患者白色念珠菌分离株的颊细胞粘附力研究

的　研究健康人和口腔扁平苔藓患者口腔白色念珠菌分离株的颊细胞粘附力。方法　应用颊细胞粘 附实验法,比较来自于健康人(26株)、糜烂型口腔扁平苔藓患者(62株)以及非糜烂型口腔扁平苔藓患者(24株)共 112株白色念珠菌对人颊细胞粘附力的大小。结果　糜烂型口腔扁平苔藓患者组的白色念珠菌分离株的平均粘附 数较健康对照组高(P<0·05),说明糜烂型口腔扁平苔藓患者组白色念珠菌分离株的颊细胞粘附力高于健康对照 组。结论　糜烂型口腔扁平苔藓患者组的白色念珠菌分离株与健康对照组相比,具有不同的毒性特征,白色念珠 菌与糜烂型口腔扁平苔藓发生发展可能相关。     

口腔扁平苔藓患者白色念珠菌分离株的毒力与遗传特征初探

目的　研究健康人和口腔扁平苔藓 (OLP)患者口腔白色念珠菌分离株的遗传特征及其与毒性特征的相关性。方法　应用随机扩增片段多态性分析法 (RAPD)分析来自于健康人 (2 6株 )、糜烂型OLP患者 (6 2株 )及非糜烂型OLP患者 (2 4株 )共 112株白色念株菌的基因型特征 ,并采用蛋黄培养基沉淀环面积测量法及颊细胞黏附实验法检测这些菌株的磷脂酶活性和颊细胞黏附力 ,以了解菌株基因型特征与毒力特征的相关性。结果　采用的RAPD分析法可大致将所有白色念珠菌分离株分为A、B、C、D 4种基因型 ;而健康对照组、糜烂型OLP和非糜烂型OLP组的白色念珠菌分离株的基因型构成均具有差异 ,其中 ,健康对照组以B、D型为主 ,糜烂型OLP组以A、C型为主 ,非糜烂型OLP组以A、D型为主 ;对 4种基因型白色念珠菌的黏附力的比较显示 ,最高为A型 ,其次为C型 ,最后为B、D型 ;对 4种基因型白色念珠菌的磷脂酶活性的比较显示 ,A、C型较高 ,其次为B型 ,最后为D型。结论　某些具有特定基因型的高毒力白色念珠菌分离株与OLP的发生发展可能相关。     

68株临床分离口腔念珠菌对4种抗真菌药的体外药敏实验结果分析

目的：评价临床致病性口腔念珠菌感染的种类及对氟康唑、两性霉素B、5-氟胞嘧啶和伊曲康唑的药物敏感性,比较各种口腔黏膜病中的感染菌株的种类和耐药比例,为临床用药提供指导。方法：收集临床菌株,经YBC Test Kit鉴定其念珠菌种类;根据NCCLS的M27-A2标准方案测定3组（口腔念珠菌病、口腔扁平苔藓合并口腔念珠菌感染、头颈部放化疗患者合并口腔念珠菌感染）菌株对4种抗真菌药物的最低抑菌浓度,并比较不同口腔黏膜病合并念珠菌感染菌株的耐药状况。结果：68株临床分离株对5-氟胞嘧啶全部敏感,91．2％对两性霉素B敏感,氟康唑和伊曲康唑的耐药比例分别为13．2％和22．1％,放化疗组的非白色念株菌比例及耐药比例明显高于口腔念珠菌病组和扁平苔藓组。结论：口腔念珠菌感染菌株对氟康唑和伊曲康唑存在较高耐药比例和交叉耐药比例,头颈部肿瘤放疗或化疗患者口腔念珠菌感染菌株的非白色念株菌比例及耐药比例明显高于口腔念珠菌病和扁平苔藓合并口腔念珠菌感染菌株。     

共生菌和致病性口腔念珠菌耐药性的比较

目的:评价和比较共生菌、致病性口腔念珠菌感染的种类及对3种抗真菌药氟康唑、5-氟胞嘧啶和伊曲康唑的药物敏感性。方法:收集临床菌株,经YBCTestKit鉴定其念珠菌种类;根据NCCLS的M27-A2标准方案,测定3组(共生菌、口腔念珠菌病、头颈部放化疗患者合并口腔念珠菌感染)菌株对3种抗真菌药物的最低抑菌浓度。结果:3组临床分离株对5-氟胞嘧啶全部敏感,3组对氟康唑和伊曲康唑均有一定的耐药比例,放化疗组的非白色念珠菌比例及耐药比例明显高于正常共生菌组和口腔念珠菌病组。结论:共生菌和致病性口腔念珠菌均对氟康唑和伊曲康唑存在一定的耐药比例和交叉耐药比例。     

复发性口腔念珠菌病患者感染源初探

目的:分析复发性口腔念珠菌病患者感染菌株的同源性,初步探讨同一病人感染反复发作是否缘于复发或再感染。方法:对4例复发性口腔念珠菌病患者口腔的10株念珠菌菌株(P1:004、022;P2:011、020、027、029;P3:007、016;P4:023、024)进行分离纯化鉴定,采用计算机系统辅助随机扩增多态性DNA(random amplifiedpolymorphic DNA,RAPD)分析,获得10株菌株的RAPD指纹图,比较菌株的同源性。结果:10株菌株中9株被鉴定为白念珠菌,1株(023)为热带念珠菌。分离自P1和P3的白念珠菌的RAPD基因型相同;P2的020、027、029号菌株基因型相同,而011号菌株不相同;P4的2株菌株不同种。结论:复发性口腔念珠菌病可能存在两方面病因:继往感染复发和/或再感染新菌株。     

舍格伦综合征患者口腔白色念珠菌耐药性与基因型的研究

目的:研究舍格伦综合征(Sjgren'ssyndrome,SS)患者口腔分离白色念珠菌株对氟康唑敏感性与基因型之间的相关性。方法:对分离自SS患者的30株口腔白色念珠菌株行微量稀释法药物敏感性试验。分别用RSD10、RSD11和RSD123种引物对药物敏感性不同的菌株进行随机扩增DNA多态性(RAPD)分析。结果:SS患者口腔分离的白色念珠菌中氟康唑耐药株与敏感株均显示出基因型的多态性,对氟康唑敏感性不同的白色念珠菌株之间的RAPD带型未见差异。结论:SS患者口腔白色念珠菌耐药现象的产生可能与药物诱导有关,而并非遗传基础所致。     

口腔念珠菌带菌与感染状态分离菌株的RAPD分析

目的 :研究念珠菌种之间及不同来源白念珠菌菌株之间的基因型相关性。方法 :对口腔白念珠菌病原菌、共生菌及非白念病原菌分别进行表型和RAPD分析。结果 :白念珠菌与非白念珠菌的RAPD带型存在差异 ,相似系数在 5 1.7%。共生菌与病原菌RAPD带型未见差异。白念珠菌种内相似系数大于 70 % ,菌株间存在DNA多态性。结论 :共生白念珠菌与病原菌未见RAPD带型差别 ,提示对口腔念珠菌病的防治应重视宿主因素在发病中的作用。     

白芍总苷和盐酸小蘖碱的抗口腔念珠菌活性研究

目的检测白芍总苷和盐酸小蘖碱(C20H18CINO4)的抗口腔念珠菌活性。方法收集口腔念珠菌正常共生菌和致病菌,经YBCTestKit鉴定念珠菌种类;依据美国临床实验室标准委员会(NCCLS)的M27-A2标准方案测定临床分离株对氟康唑、白芍总苷、盐酸小蘖碱的药物敏感性。结果白芍总苷和盐酸小蘖碱对口腔念珠菌正常共生菌和致病菌均具有抗念珠菌活性,尤其具有抗光滑念珠菌的活性。结论白芍总苷和盐酸小蘖碱的抗真菌机制可能和氟康唑不同;白芍总苷和盐酸小蘖碱可用于治疗和预防口腔念珠菌感染。     

Yeast species and biotypes associated with oral leukoplakia and lichen planus

Of 36 patients, 17 had oral leukoplakia, including homogeneous and nonhomogeneous types, and 19 had reticular lesions of oral lichen planus. A sample of yeast flora in each patient was taken from the pathologic lesion as well as from normal-appearing mucosa. The isolated yeasts were identified according to species level, and identification was extended beyond the species level for one species, Candida albicans, to reveal the biotype by means of the Odds and Abbott procedure comprising tests for acid and salt tolerance, proteinase production, resistance to 5-fluorocytosine and safranine, and assimilation of urea, sorbose, and citrate. Yeasts were present in the lesions of 82% of leukoplakia patients, compared to 37% of lichen planus patients, a frequency of yeasts corresponding to that in healthy adults. C. albicans was the dominating species in lesions of both diseases, constituting 82% of all yeasts in the leukoplakia lesions. In addition, the following species were identified: Candida tropicalis, Candida pintolopesii, Torulopsis glabrata, and Saccharomyces cerevisiae. Eighteen biotypes of C. albicans were encountered, the most frequently occurring biotypes being 355 and 177. Differences between C. albicans biotypes isolated from pathologic and normal mucosa were encountered in five of eleven leukoplakia patients and in one of three lichen planus patients. This indicates that the oral cavity comprises several ecologic niches for yeasts. As nonhomogeneous leukoplakias are more likely to develop into carcinoma than are homogeneous leukoplakias, it is interesting to note that the C. albicans biotypes isolated from nodular lesions (one type of nonhomogeneous leukoplakia)--biotypes 145, 175, and 575--rarely occur.(ABSTRACT TRUNCATED AT 250 WORDS)     

念珠菌与口腔扁平苔藓关系的临床研究

目的：阐明口腔扁平苔藓（Oral lichen planus,OLP）与白色念珠菌（candida albicans,CA）关系同时,明确其与非白念致病性念珠菌关系.方法：选取40例糜烂型及非糜烂型OLP患者及20例健康志愿者.采用含漱液浓缩培养法,并结合应用芽管试验、厚膜孢子形成试验及温度试验常规培养等方法分离、鉴定各组中致病念珠菌菌种.结果：糜烂型OLP组念珠菌培养阳性率（60%）显著高于非糜烂型OLP组（25%）和对照组（15%）的念珠菌阳性培养率（p＜0.01）.糜烂型OLP组念珠菌阳性培养菌落数显著高于对照组及非糜烂型OLP组念珠菌阳性培养菌落数.糜烂型OLP中CA分离率（64%）,显著低于非糜烂型OLP组（88%）（p＜0.05）和对照组（100%）（p＜0.01）中CA分离率.糜烂型OLP中都柏林念珠菌（Candida dubliniensis,CD）分离率（14.1%）高于非糜烂型OLP组中CD分离率（4%）（p＜0.05）.其他非白念致病念珠菌的分离率也以糜烂型OLP组（21.9%）为最高,显著高于非糜烂型OLP组（8%）（p＜0.05）.结论：糜烂型OLP所伴念珠菌感染主要为CA.糜烂型OLP所伴念珠菌感染的念珠菌菌种复杂,非白念致病菌念珠菌尤其是CD起着重要作用.     

A prospective study of findings and management in 214 patients with oral lichen planus.

The findings in this prospective study of 214 patients with oral lichen planus were similar to those found in our 1985 evaluation of 570 patients with oral lichen planus. These two groups of patients with oral lichen planus patients constitute the largest series from one clinic. Oral lichen planus was found mainly in women and most commonly on the buccal mucosa. Spontaneous remissions were infrequent (6.5%), as were malignant transformations (2.3%) in a mean follow-up of 7.5 years. The erosive form of oral lichen planus was most common and was almost always associated with pain. Reproducibly successful management of this T-lymphocyte disease was obtained by selective use of systemic and/or topical corticosteroids. Oral lichen planus was not associated with any evident systemic disease, drug, smoking, or genetic predisposition. Although statistically Candida albicans does not appear to occur disproportionately in large samples of patients with oral lichen planus, in some of the Candida-positive patients, antifungal medications appeared to be useful.     

Clonal identity of Candida albicans in the oral cavity and the gastrointestinal tract of pre-school children

The clonal relationship between oral and fecal Candida albicans isolated from children of pre-school age was examined using RAPD analysis. Significantly higher levels of C. albicans were found in saliva, dental plaque, carious specimens and stools of 56 patients with severe caries as compared to 52 healthy control subjects. The highest prevalence was found in carious specimens and a strong correlation was observed between its presence in saliva, dental plaque, carious specimen and feces. RAPD analysis of isolates from 23 patients with simultaneous oral and fecal C. albicans revealed clonal counterparts present in both oral and stool samples in 15 cases; five patients harbored closely related strains; and three patients harbored unrelated strains. Our results demonstrate a strong correlation between oral and gastrointestinal C. albicans colonization. We assume that carious teeth may constitute an ecologic niche for C. albicans potentially responsible for recurrent oral and non-oral candidiasis.     

Reduced in vivo cell-mediated immune responses to mumps, tuberculin, and streptokinase/streptodornase but not to Candida albicans in oral lichen planus

Oral lichen planus is considered to be a T-cell-mediated disease. The purpose of this study was to investigate the capacity of T-lymphocytes in oral lichen planus patients to respond to a number of commonly encountered environmental antigens in vivo. To do this, we assessed dermal delayed-type hypersensitivity responses to mumps, streptokinase/streptodornase, Candida albicans, and purified protein derivative of tuberculin (PPD) in 17 oral lichen planus patients and in matched controls. Reduced induration in response toward mumps, PPD, and streptokinase/streptodornase was demonstrated in oral lichen planus patients compared with controls. In addition, the total sum of induration diameters was decreased in the patients. However, C. albicans stimulation resulted in similar levels of response in both groups. The differences in induration size between matched patients and controls for mumps and PPD were thus significantly greater than the corresponding differences for the C. albicans antigen. This suggests that a selective difference in the response to these antigens exists in oral lichen planus patients. The results may point to a loss of memory T-helper function to infrequently encountered environmental antigens, represented by mumps, PPD, and streptokinase/streptodornase, contrarily to memory function to common antigens (C. albicans), which seem to be unaffected.