非妊娠期妇女BV和VVC发病状况及相关危险因素分析  

The Prevalence and Risk Factors of Bacterial Vaginosis and Vulvovaginal Candidiasis in Nonpregnant Women

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

机构地区：[1]四川大学华西第二医院,四川成都610041 [2]北京大学第一医院,北京100034 [3]北京大学深圳医院,广东深圳518036 [4]上海交通大学医学院附属仁济医院,上海200127 [5]北京大学第三医院,北京100083

出　　处：《实用妇产科杂志》2008年第5期283-286,共4页Journal of Practical Obstetrics and Gynecology

基　　金：“十五”国家科技攻关计划课题

摘　　要：目的：探讨细菌性阴道病（bacterial vaginosis,BV）和外阴阴道假丝酵母菌病（vulvovaginal candidiasis,VVC）在非妊娠期妇女的发病情况及其危险因素。方法：随机选取800例非妊娠期妇女,通过阴道分泌物检查、需氧菌及假丝酵母菌培养,了解BV和VVC患病情况,并结合问卷对可能的危险因素行单因素多变量非条件Logistic回归分析。结果：BV和VVC在受试人群的患病率分别为8.9%和8.1%。BV的危险因素为：阴道冲洗每周≥2次（OR2.438,95%CI1.285-4.626）和丈夫经常出差（OR1.946,95%CI1.046-3.620）;VVC的危险因素为：小学以下文化程度（OR3.217,95%CI1.326-7.805）。细菌培养结果以检出率表示,BV组与对照组比较,加德纳菌显著增加（70.4% vs 13.1%,P〈0.01）,乳杆菌显著减少（18.3% vs 65.4%,P〈0.01）;VVC组与对照组比较,白色假丝酵母菌（52.3% vs 3.1%,P〈0.01）和光滑假丝酵母菌（20.0% vs 3.7%,P〈0.01）均显著增加,乳杆菌减少（53.8% vs 65.4%,P〈0.05）。结论：BV和VVC均与阴道菌群失调有关,BV病原体以加德纳菌为主,阴道冲洗过频和丈夫经常出差是其危险因素;VVC病原体以白色假丝酵母菌和光滑假丝酵母菌为主,低学历是其危险因素;而BV和VVC与性行为的关系尚需进一步研究。Objective：To investigate the prevalence and high risks of bacterial vagincsis （BV） and vulvovaginal canclidiasis （WC） in nonpregnant women.Methods：800 nonpregnant outpatient patients were enrolled randomly. The demographic information or behavior pattem was collected by self-completed questionnaire. Vaginal secretions were taken for pH detection, leucorrhea routine examination, aerobia and eumycete culture to detect BV and WC. Univariate and multivariate OR and 95% CI of risk factors were determined using logistic regression. Results： The prevalence of BV and VVC were 8.9% and 8.1% respectively. BV was associated with douching more than twice a week （OR 2.438,95% CI 1.285 - 4.626） and a condition of husband＇s frequent business trips （OR 1.946, 95%CI 1.046- 3.620）. VVC was associated with less than primary school educational background （OR 3.217, 95% CI 1.326-7.805）. When positive percentages were analyzed in culture, BV group had a significant increase in gardnerella （70.4% vs. 13.1%, P〈0.01） and a decrease in lactobacillus （18.3% vs. 65.4%, P〈0.01） compared with normal group. In VVC group, candida albicans and candicla glabrata were increased compared with normal group （52.3% vs. 3.1% and 20.0% vs. 3.7% respectively, P〈0.01） while lactobacillus was decreased （53.8% vs. 65.4%, P 〈 0.05）. Conclusions： BV and WC are associated with dysbacteriosis in vagina. Gardnerella is one of the most important pathogens in BV, while douching and a condition of husband＇s frequent business trips are risk factors. WC was mostly caused by candida albicans or candida glabrata, while low educational background is a risk factor. Further studies were needed to investigate the relationships between sexual behaviors and WC or BV.

关 键 词：细菌性阴道病 外阴阴道假丝酵母菌病 危险因素 

分 类 号：R711.73[医药卫生—妇产科学]