800例女性阴道菌群分布调查及影响因素的研究  

Characterization of vaginal microbial communities in 800 adult healthy women

作　　者：谢灵遐[1] 贾海军[1] 胡丽娜[1] 江咏梅[2] 廖秦平[3] 刘朝晖[3] 樊尚荣[4] 狄文[5] 耿力[6] 

机构地区：[1]四川大学华西第二医院妇产科,成都610041 [2]四川大学华西第二医院检验科,成都610041 [3]北京大学第一医院妇产科 [4]北京大学深圳医院妇产科 [5]上海交通大学医学院附属仁济医院妇产科 [6]北京大学第三医院妇产科

出　　处：《现代妇产科进展》2008年第2期81-84,共4页Progress in Obstetrics and Gynecology

基　　金："十五"国家科技攻关计划课题基金资助

摘　　要：目的:探讨女性阴道的菌群分布及其影响因素。方法:对成都地区800例妇女的阴道分泌物进行细菌培养、测定pH值和检查白带清洁度。结果:正常女性阴道内乳酸杆菌培养阳性率为59.8%,其余几种主要的菌群及其培养阳性率分别为棒状杆菌(29.0%),凝固酶阴性葡萄球菌(20.6%),加德纳氏菌(18.1%),粪肠道球菌(18.4%),大肠埃希菌(8.9%)。50岁以下各组女性的阴道菌群检出率无统计学差异(P>0.05);50岁以上各组妇女的乳酸杆菌显著降低(40.0%vs60.4%,P<0.05)。以pH≤4.5划分阴道正常和异常酸性环境,异常组乳酸杆菌的检出率明显少于正常组(34.4%vs66.2%,P<0.001),其他菌群检出率显著上升(P<0.02),加德纳氏菌的增加最为显著(35.6%vs13.7%,P<0.001)。白带清洁度异常组乳酸杆菌的检出率显著少于正常组(42.9%vs70.9%,P<0.001),加德纳氏菌检出率显著增加(36.4%vs7.2%,P<0.001),其余菌群检出率无统计学差异(P>0.05)。慢性宫颈炎组与正常组相比,菌群分布差异无显著性(P>0.05)。结论:女性阴道内有多种菌群存在,优势菌为乳酸杆菌。阴道pH值升高、绝经期、白带清洁度异常会抑制乳酸杆菌生长,破坏阴道菌群的平衡,从而增加条件致病菌繁殖和阴道炎症发生的机会。Objective： To study the microbial flora distribution in the normal female genital tract. Methods： Microbial culture of vaginal swab, routine test of leukorrhea and pH value were performed in 800 cases of routine physical check-up women in Chengdu. Results：The microbial flora in normal female vagina was composed mainly by lactobacillus（59.8% ）,followed by others as corynebacterium （ 29. 0% ）, CNS （ coagulase-negative staphycoccus ） （20. 6% ）, Gardnerella vaginalis （ 18. 1% ）, faecium enterococcus （ 18.4% ）, Escherichia coli （8.9%）. The detecting rate of all vaginal flora showed no statistical significance in women younger than 50 years old, while the lactobacillus decreased significantly in women older than 50（40.0% vs 60.4% ,P 〈0. 05 ）. Defined the normal vaginal setting as pH≤4.5 ,the lactobacillus decreased significantly in the abnormal group（34.4% vs 66.2% ,P 〈0.001 ） ,while others increased （P 〈0.02） ,with Gardnerella vaginalis showing the most significant rise（35.6% vs 13.7% ,P 〈0.001 ）. The lactobacillus also decreased significantly in the group with abnormal leukorrhea cleaning degree（42.9% vs 70.9% ,P 〈0.001 ） ,as Gardnerella vaginalis showing an distinctive increase（36. 4% vs 7.2% ,P 〈 0.001 ） and others no significance（ P 〉 0. 05）. No statistical significance was found between the chronic cervicitis group and the control group （ P 〉 0.05 ）. Conclusion： In all kinds of microbial flora, lactobacillus is in the predominant place, pH value increase, menopause and abnormality of leukorrhea can inhibit the growth of lactobacillus, which in turn increases the reproduction of other conditioned pathogen and the occurrence of vaginal inflammation due to the disturbance of microbial balance.

关 键 词：菌群分布 阴道 PH值 乳酸杆菌 白带 

分 类 号：R737.31[医药卫生—肿瘤]