Objective To explore the risk factors and the treatment of Candida esophagitis. Methods 98 patients with Candida esophagitis were collected to explore their high risk factors. 88 patients were randomized to the Fluconazole group and the Nysfungin group and received 2 weeks therapy. All patients received drug sensitive test and endoscopic review to evaluate the efficacy. Results High risks of the Candida esophagitis included the use of broad-spectrum antibiotics, PPI, tumor and diabetes (P<0.05). The resistant rate of Fluconazole was 8. 6% while the Nysfungin was 7. 1% (P >0.05). The recovery rates were similar in two groups (P >0.05). The cost was less in the Nyfungin group (P < 0.05). There was no difference in side effects between the two groups (P >0.05). Conclusion Nysfungin therapy is safe, economic and efficient for Candida esophagitis.%目的 了解念珠菌性食管炎的危险因素和治疗方案的选择.方法 念珠菌性食管炎患者98例,对照组196例,分析其高危因素.念珠菌性食管炎组剔除10例长期服用PPI的患者后,剩余88例按抽签单双号方式随机分为氟康唑治疗组和制霉素治疗组各44例,分别给予2周的抗真菌治疗,疗程结束后复查胃镜,分析治疗效果,并对所有患者进行药物敏感测试.结果 念珠菌性食管炎的高危因素包括应用广谱抗生素(OR =5.66,x2=20.14,P＜0.05)、糖尿病(OR=4.00,x2 =7.96,P＜0.05)、质子泵抑制剂(OR =3.59,x2=6.46,P＜0.05)、恶性肿瘤(OR =3.41,x2=10.40,P＜0.05)等.治疗效果方面,制霉素治疗组37例(84.1％)患者完全治愈,5例(11.4％)患者治疗有效,2例(4.5％)患者治疗无效;氟康唑治疗组35例(79.5％)患者完全治愈,8例(18.2％)患者治疗有效,1例(2.3％)患者治疗无效;两组在治愈率方面无统计学差异(P＞0.05).氟康唑耐药率为8.6％,制霉素为7.1％,无统计学差异(P＞0.05).制霉菌素组治疗费用明显低于氟康唑组(P＜0 05),二者在药物副反应方面无明显差异(P＞0.05).结论 使用广谱抗生素、质子泵抑制剂、合并恶性肿瘤、糖尿病是念珠菌性食管炎的危险因素,制霉素可以作为治疗念珠菌性食管炎一种安全、有效、经济的选择.
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