不同浓度碳酸氢钠联合制霉菌素对系统性红斑狼疮口腔及肺部感染的预防效果

樊育苗; 郑朝晖; 封朵朵; 罗恒; 王青

doi:10.16766/j.cnki.issn.1674-4152.004443

不同浓度碳酸氢钠联合制霉菌素对系统性红斑狼疮口腔及肺部感染的预防效果

doi: 10.16766/j.cnki.issn.1674-4152.004443

1.
中国人民解放军空军军医大学第一附属医院临床免疫科，陕西西安 710032
2.
中国人民解放军空军军医大学第一附属医院麻醉与围手术医学科，陕西西安 710032

基金项目:

国家自然科学基金面上项目 62272468

详细信息

通讯作者:
王青，E-mail: xjyy112233@163.com

中图分类号: R593.241 R519
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出版历程
- 收稿日期: 2026-01-06

The preventive effect of combining different concentrations of sodium bicarbonate with nystatin on oral and pulmonary infections in SLE patients

1.
Department of Clinical Immunology, First Affiliated Hospital of the Military Medical University of the Chinese People's Liberation Army Air Force, Xi'an, Shaanxi 710032, China

摘要

摘要: 目的探究不同浓度碳酸氢钠漱口液联合制霉菌素对系统性红斑狼疮(SLE)患者口腔及肺部感染的预防效果，为临床防治提供科学参考。方法选取2023年4月—2024年5月中国人民解放军空军军医大学第一附属医院收治的97例SLE患者为研究对象，采用随机数字表法分为A组32例、B组32例、C组33例。A组使用制霉菌素漱口液，B组在A组的基础上加用2%碳酸氢钠漱口液，C组在A组的基础上加用4%碳酸氢钠漱口液。比较3组患者口腔及肺部感染率、感染发生和治愈时间、口腔pH值和疼痛程度。结果 C组口腔真菌感染率[9.09%(3/33) vs. 37.50%(12/32) vs. 31.25%(10/32)]和肺部真菌感染率[6.06%(2/33) vs. 31.25%(10/32) vs. 25.00%(8/32)]低于A组和B组(P＜0.05)。口腔真菌感染、肺部真菌感染发生时间A组＜B组＜C组，治愈时间A组＞B组＞C组(P＜0.05)。A组和B组口腔感染程度较C组严重(P＜0.05)。患者第1天、第5天及第10天含漱后的口腔pH值与VAS评分A组＜B组＜C组(P_组间＜0.05)，且随着时间延长，VAS评分差异逐渐减小(P_交互＜0.05)。结论 4%的碳酸氢钠漱口液联合制霉菌素漱口液可提高SLE患者口腔pH值，降低口腔及肺部真菌感染率，缩短治疗时间，预防效果显著。
- 系统性红斑狼疮 /
- 碳酸氢钠 /
- 制霉菌素 /
- 口腔真菌感染 /
- 肺部真菌感染
Abstract: Objective To investigate the preventive efficacy of sodium bicarbonate mouthwash at various concentrations combined with nystatin against oral and pulmonary infections in patients with systemic lupus erythematosus(SLE), and to provide evidence for clinical prevention and treatment. Methods A total of 97 SLE patients admitted to the First Affiliated Hospital of the Military Medical University of the Chinese People's Liberation Army Air Force from April 2023 to May 2024 were randomly assigned to three groups: Group A (n=32), Group B (n=32) and Group C (n=33). Group A received nystatin mouthwash alone. Group B received nystatin plus 2% sodium bicarbonate mouthwash. Group C received nystatin plus 4% sodium bicarbonate mouthwash. We compared oral and pulmonary fungal infection rates, time to infection onset and resolution, oral pH levels and pain intensity among the groups. Results Group C had lower rates of oral fungal infection[9.09% (3/33) vs.37.50% (12/32) vs.31.25% (10/32)] and pulmonary fungal infection [6.06% (2/33) vs.31.25% (10/32) vs.25.00% (8/32)] compared to Groups A and B(P < 0.05). The onset of both oral and pulmonary fungal infections occurred earliest in Group A and latest in Group C, while cure times were longest in Group A and shortest in Group C (P < 0.05). Oral infection severity was higher in Groups A and B than in Group C(P < 0.05). After mouth rinsing on days 1, 5, and 10, oral pH and VAS scores were lowest in Group A and highest in Group C (P_intergroup < 0.05). These differences decreased over time(P_interaction < 0.05). Conclusion Combining 4% sodium bicarbonate mouthwash with nystatin increases oral pH in SLE patients, reduces the risk of oral and pulmonary fungal infections, shortens treatment time and provides effective prophylaxis.
- Systemic lupus erythematosus /
- Sodium bicarbonate /
- Nystatin /
- Oral fungal infection /
- Pulmonary fungal infection
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表 1 3组SLE患者一般资料比较

Table 1. Comparison of general characteristics among three groups of SLE patients

组别	例数	年龄($\bar{x} \pm s$，岁)	性别(男性/女性，例)	病程($\bar{x} \pm s$，月)	SLEDAI-2000评分($\bar{x} \pm s$，分)
A组	32	36.69±5.18	4/28	28.13±5.81	11.91±2.02
B组	32	36.56±4.93	6/26	28.66±6.88	11.75±2.13
C组	33	35.97±5.14	3/30	28.15±5.50	12.03±1.96
统计量		0.186^a	1.339^b	0.078^a	0.154^a
P值		0.831	0.512	0.925	0.857
注：^a为F值，^b为χ²值。

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表 2 3组SLE患者口腔及肺部感染率比较[例(%)]

Table 2. Comparison of oral and pulmonary infection rates among three groups of SLE patients [cases (%)]

组别	例数	口腔真菌感染	肺部真菌感染
A组	32	12(37.50)	10(31.25)
B组	32	10(31.25)	8(25.00)
C组	33	3(9.09)^ab	2(6.06)^ab
χ²值		7.603	6.858
P值		0.022	0.032
注：与A组比较，^aP＜0.05；与B组比较，^bP＜0.05。

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表 3 3组SLE患者口腔及肺部感染发生和治愈时间比较($\bar{x} \pm s$，d)

Table 3. Comparison of onset and healing time of oral and pulmonary infections among three groups of SLE patients ($\bar{x} \pm s$, d)

组别	例数	口腔真菌感染		肺部真菌感染
组别	例数	发生时间	治愈时间	发生时间	治愈时间
A组	32	17.42±2.84	14.75±2.99	15.60±3.24	16.90±3.67
B组	32	22.20±5.53^a	11.60±3.13^a	20.88±4.22^a	12.50±2.33^a
C组	33	31.33±2.08^ab	7.00±1.00^ab	29.00±2.83^ab	8.00±1.41^ab
F值		14.416	9.308	12.866	9.114
P值		＜0.001	0.001	＜0.001	0.002
注：与A组比较，^aP＜0.05；与B组比较，^bP＜0.05。

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表 4 3组SLE患者口腔感染程度比较[例(%)]

Table 4. Comparison of oral infection severity among three groups of SLE patients [cases (%)]

组别	例数	0度	Ⅰ度	Ⅱ度	Ⅲ度	Ⅳ度
A组	32	20(62.50)	7(21.88)	2(6.25)	2(6.25)	1(3.12)
B组	32	22(68.75)	5(15.62)	3(9.38)	2(6.25)	0
C组	33	30(90.91)	2(6.06)	1(3.03)	0	0
注：3组口腔感染程度比较，H=7.762，P=0.022。

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表 5 3组SLE患者口腔真菌感染患者不同时间口腔pH值比较($\bar{x} \pm s$)

Table 5. Comparison of oral pH values at different time points among three groups of SLE patients with oral fungal infections ($\bar{x} \pm s$)

组别	例数	第1天	第5天	第10天	F值	P值
A组	32	5.08±0.40	5.64±0.44^c	6.05±0.41^cd	74.886	＜0.001
B组	32	6.07±0.50^a	6.75±0.54^ac	7.51±0.45^acd	50.739	＜0.001
C组	33	7.07±0.15^ab	7.73±0.15^abc	8.20±0.20^abcd	2.073	0.101
F值		31.486	30.615	51.192
P值		＜0.001	＜0.001	＜0.001
注：与A组比较，^aP＜0.05；与B组比较，^bP＜0.05；与第1天比较，^cP＜0.05；与第5天比较，^dP＜0.05；F_时间=123.026，P_时间＜0.001；F_组间=50.739，P_组间＜0.001；F_交互=3.115，P_交互=0.064。

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表 6 3组SLE患者口腔真菌感染患者不同时间VAS评分比较($\bar{x} \pm s$，分)

Table 6. Comparison of VAS scores at different time points among three groups of SLE patients with oral fungal infections ($\bar{x} \pm s$, points)

组别	例数	第1天	第5天	第10天	F值	P值
A组	32	3.92±0.51	3.42±0.51^c	2.67±0.49^cd	119.674	＜0.001
B组	32	4.80±0.63^a	4.10±0.74^ac	3.10±0.32^acd	22.065	＜0.001
C组	33	6.67±0.58^ab	5.33±0.58^abc	3.67±0.58^abcd	6.430	＜0.001
F值		29.107	12.074	7.057
P值		＜0.001	＜0.001	0.004
注：与A组比较，^aP＜0.05；与B组比较，^bP＜0.05；与第1天比较，^cP＜0.05；与第5天比较，^dP＜0.05；F_时间=237.395，P_时间＜0.001；F_组间=22.065，P_组间＜0.001；F_交互=12.836，P_交互＜0.001。

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