外阴阴道念珠菌病的临床特征和抗真菌药物敏感性研究  

Clinical Characteristics of Vulvovaginal Candidiasis and Antifungal Susceptibilities of Candida Species Isolates

作　　者：樊尚荣[1] 刘小平[2] 严冬霞[1] 李建武[2] 高淑红[1] 

机构地区：[1]北京大学深圳医院妇产科,深圳市518036 [2]北京大学深圳医院检验科

出　　处：《中国全科医学》2010年第27期3068-3070,共3页Chinese General Practice

基　　金：国家"十五"科技攻关计划课题(2004BA720A05-01);深圳市科技局科技计划课题(JA200505270419B;200702108;200703031)

摘　　要：目的探讨外阴阴道念珠菌病(VVC)的临床特征及其对抗真菌药物的敏感性。方法于2003—2006年连续对妇科门诊患者进行VVC发病情况调查,观察单纯型VVC和复杂型VVC的临床特征、念珠菌菌株分布以及白念珠菌株对抗真菌药物的敏感性。结果 1070例VVC患者390例(36.5%)为单纯型VVC,680例(63.5%)为复杂型VVC。单纯型VVC、重度VVC、非白念珠菌VVC及复发性VVC外阴瘙痒、外阴灼痛、阴道充血、白带增多及临床特征总评分分布不同,差异有统计学意义(P<0.05)。1070例VVC患者分离出1094株念珠菌,白念珠菌占90.4%(967/1094株),有24例患者同时感染2种念珠菌。对其中206株白念珠菌进行体外药敏试验,均对制霉菌素敏感,98.1%对克霉唑敏感,92.7%对氟康唑敏感,85.0%对伊曲康唑敏感,79.1%对益康唑敏感,65.5%对咪康唑敏感,53.9%对酮康唑敏感。结论白念珠菌是VVC主要致病菌,白念珠菌对抗真菌药物的耐药性不常见,制霉菌素和克霉唑可供选择治疗白念珠菌VVC。Objective To investigate the clinical characteristics of vulvovaginal candidiasis （VVC）,the Candida species involved and the antifungal susceptibility of Candida species isolated from patients with VVC.Methods From 2003 to 2006 the prevalence of VVC was successively investigated in the department of obstetrics and gynecology to study the clinical characteristics of simple and complex VVC,distribution of Candida species,and the antifungal susceptibility.Results Of the 1 070 VVC patients reported in this study,390 （36.5%） were uncomplicated VVC,and 680 （63.5%） were complicated VVC.The distributions of pruritus vulvae,burning pain,vaginal engorgement,leukorrhagia,and total score of clinical characteristics showed significant differences among the patients with simple VVC,severe VVC,VVC of non-Candida albicans,and recurrent VVC （P0.05）.1 094 strains of Candida species were isolated from 1 070 VVC patients,of which 24 were identified as having two species of Candida.All the 206 isolates of Candida albicans were susceptible to nystatin,98.1% of the isolates were susceptible to clotrimazole,92.7% to fluconazole,85.0% to itraconazole,79.1% to econazole,65.5%to miconazole,and 53.9% to ketoconazole.Conclusion Candida albicans is the predominant Candida species in VVC.Resistance of vaginal Candida albicans isolates to antifungal agents is infrequent,and nystatin and clotrimazole can be chosen to treat recurrent VVC of Candida albicans.

关 键 词：念珠菌 白色 抗真菌药 念珠菌病 外阴阴道 微生物敏感性实验 

分 类 号：R711.31[医药卫生—妇产科学]