| Objective The risk factors of oral candidiasis and the influencing factors of fluconazole curative effect in the elderly were analyzed to provide clinical basis for the correct and rational use of antifungal drugs,the prevention of oral candidiasis and the improvement of treatment effect.Methods The first part: the observation group was 181 elderly patients with oral candidiasis,and the control group was 186 elderly patients with non-oral candidiasis.By means of questionnaire survey,data were collected from 7 aspects of local oral environment and behavior of systemic diseases of oral mucosa in demographic background and socio-economic background,Relevant risk factors were screened by single factor analysis method,and variables with statistical significance were included in multi-factor analysis to identify relevant risk factors affecting oral candidiasis in the elderly.The second part: 181 elderly patients with oral candidiasis were investigated by questionnaire,To observe the clinical efficacy of fluconazole in patients,and to explore the related factors affecting the efficacy of fluconazole in oral candidiasis in the elderly through the patient's medication compliance and the use of azole drugs;Combined with the data collected in the first part of the survey,the factors influencing the recurrent oral candidiasis in the elderly were studied.Results1.Risk factors affecting oral candidiasis in the elderly.Results of univariate analysis: education,occupation,monthly income,diabetes,digestive system disease,oral lichen planus,recurrent aphthous ulcer,oral hygiene,antibiotic/hormone use,denture wearing are associated with oral candidiasis in the elderly(P<0.05).Multivariate analysis results: Wearing denture,antibiotics/hormones,oral hygiene,systemic diseases,oral mucosal diseases are risk factors for oral candidiasis in the elderly(P<0.05).The OR value of wearing denture was 9.509(95%CI=4.885~18.508).The OR value of antibiotics/hormones was 9.410(95%CI=4.013~22.065).The OR value of Calculus Index I ° was 3.126(95%CI=1.236~7.904),The OR value of Calculus Index II ° was 11.636(95%CI=4.496~30.114),The OR value of Calculus Index III ° was 17.697(95%CI=7.157~43.758),The degree of oral hygiene and the occurrence of oral candidiasis showed a progressive relationship.Among systemic diseases,Sjogren's syndrome had the greatest impact,with an OR value of 13.91(95%CI=4.93~39.247),followed by diabetes,with the OR value of 12.113(95%CI=5.118~28.669),and digestive system diseases,with an OR value of3.061(95%CI=1.309~7.16).Among oral mucosal diseases,oral lichen planus had the greatest impact,with an OR value of 7.277(95%CI=3.144~16.841),and the recurrent aphthous ulcer with an OR value of 3.735(95%CI=1.721~8.109).2.The influencing factors of fluconazole curative effect in the elderlyAmong 181 elderly patients with oral candidiasis,60(33.10%)who had used azoles had recurrent oral candidiasis.The results showed that gender?smoking and wearing dentures were correlated with recurrent oral candidiasis(P<0.05).The results of multi-factor analysis on the curative effect of fluconazole showed that:medication compliance and a history of taking azole drugs was a relevant factor affecting the curative effect of fluconazole(P<0.05),OR values are 4.879 and5.412,respectively,Elderly patients with a history of taking azole drugs and poor medication compliance had a relatively poor curative effect of fluconazole in thetreatment of oral candidiasis.Conclusion1.The risk factors for oral candidiasis in the elderly are oral hygiene conditions,Sjogren's syndrome,diabetes,digestive disease,oral lichen planus,recurrent aphthous ulcer,wearing a denture,antibiotics/hormones before onset.2.The recurrent occurrence of oral candidiasis in the elderly is mainly related to gender,smoking,denture wearing.male patients,patients who have the habit of smoking,wearing removable denture were more likely to have recurrent oral candidiasis.3.The factors affecting the curative effect of fluconazole in oral candidiasis in the elderly include: medication compliance and history of taking azole drugs,fluconazole was less effective in patients with poor medication compliance or previous use of azoles. |
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