摘要
目的 研究中国妇产科门诊就诊患者的阴道微生态状况.方法 通过多中心断面研究的方法,全国9家协作医院参加,每家医院收集妇科门诊就诊的连续200余例患者,进行阴道微生态检查,分析她们的阴道微生态状况及相关影响因素.结果 本研究共收集标本2093例,临床诊断滴虫阴道炎5.5%(115/2093);外阴阴道假丝酵母菌病15.9%(333/2093),另可见单独孢子检出4.1%(86/2093);细菌性阴道病18.8%(394/2093).阴道菌群的分布为菌群正常患者仅占571/2093,27.3%,菌群正常但功能下降480/2093,23%,菌群抑制79/2093,3.8%,菌群异常(非BⅤ型) 312/2093,14.9%,菌群异常(BV中间型)280/2093,13.4%,菌群异常(BⅤ型)369/2093,17.6%.阴道分泌物平均pH值4.58 ±0.495.滴虫和细菌性阴道病的发生率长江南北无显著差异,但真菌假菌丝的检出南方地区明显增高,并且南方地区单独检出真菌孢子的几率显著高于北方.对微生态影响因素的分析显示年龄和避孕方式是重要的影响因素.菌群抑制组年龄(49.64 ±16.68)岁,显著高于其他微生态表现组;口服避孕药组发生菌群异常的比例为20/50,40%,使用宫内节育器组发生菌群异常的比例为63/172,36.6%,与使用安全套者91/327,27.8%比较,显著升高.发现菌群正常组白带异常的发生率37.7%,显著低于其他菌群异常组别.结论 本研究展示了中国医院就诊人群的阴道微生态表现,发现阴道微生态与年龄、地域、避孕方式相关.微生态异常的典型表现为白带增多.(中华检验医学杂志,2018,41:287-291)
Abstract
Objective To study the vaginal microecology of the patients in the outpatient department of Obstetrics and gynecology in China.Methods A multicenter cross-sectional study was conducted in gynecologic clinic of 9 collaborative hospitals in China.200 consecutive patients were collected in each hospital and their vaginal microecology combined with related factors were analyzed.Results A total of 2 093 specimens were collected in this study.The detection rate of Trichomonas was 5.5%(115/2 093). The detection rate of Candida mycelia was 15.9%(333/2 093), with germinal spores was 4.1%(86/2093).The detection rate of bacterial vaginosis was 18.8%(394/2 093).The distribution results of vaginal flora in patients showed that the normal flora accounted for only 27.3%(571/2 093).The normal flora with the insufficiency of H2O2 accounted for 23%(480/2 093).The bacteria inhibiting flora accounted for 3.8%(79/2 093).The abnormal microflora(non BV type)accounted for 14.9%(312/2 093).The abnormal microflora(BV intermediate type)accounted for 13.4%(280/2 093).The abnormal microflora(BV type)accounted for 17.6%(369/2 093).The average pH of vaginal discharge was 4.58 ±0.495.There was no significant difference of the incidence of trichomonas and bacterial vaginosis between north and south of the Yangtze river, while the detection rate of fungal hyphae and the fungal spores is significantly higher in the south than that in the north.The analysis results of factors affecting the microecology showed that age and contraception methods were two important factors.The patients′age from bacteria inhibition group was 49.64 +16.68 which was significantly higher than that of the other microecology groups.The proportion of abnormal microflora of patients from the oral contraceptive group was 40%(20/50).The proportion of abnormal microflora of patients from IUD group was 36.6%(63/172).Compared with these two contraception methods, the proportion of abnormal microflora of patients from condoms usage group was 27.8%(91/327)which was significantly lower.The incidence of abnormal leucorrhea in the normal group was 37.7%, which was significantly lower than that of other abnormal groups.Conclusion This study showed the vaginal microecology status of the Chinese outpatient ′s clinic and found that the vagina microecology was related to age, region and contraceptive methods.The typical manifestation of microecological abnormality is the increase of leucorrhea.(Chin J Lab Med,2018, 41:287-291)
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维普
万方数据