纵向研究妊娠期妇女的阴道微生态状况  

Longitudinal analysis of the vaginal microecology in pregnancy

作　　者：王叶平[1,2] 潘利琴[1,2] 邵洁白[1,2] 王姿斌[1,2] 沙丽晓[1,2] 王佐[1,2] 林晓华[1,2] 

机构地区：[1]温州市第三人民医院 [2]温州医学院温州市第三临床学院妇产科,浙江温州325000

出　　处：《中国微生态学杂志》2012年第5期437-439,442,共4页Chinese Journal of Microecology

基　　金：温州市科技计划项目(Y20090291)

摘　　要：目的分析妊娠期妇女阴道微生态状况的纵向变化。方法选择健康无症状单胎妊娠期妇女50例,分别于孕早期(10.2±2.1)周、孕中期(24.6±3.7)周、孕晚期(33.2±3.4)周,取其阴道分泌物,进行pH、H2O2含量检测及细菌培养,并经革兰染色后在油镜下观察,进行阴道微生态(阴道菌群的密集度、多样性、优势菌、炎症反应状况等)状况评价。结果 (1)50例孕妇中,孕早期38例(76%)阴道微生态正常,其中31例(81.58%)整个孕期维持阴道微生态正常,7例(18.42%)孕妇于孕中期或孕晚期转变为阴道微生态失调;12例(24%)孕早期阴道微生态失调,其中6例(50%)于孕中期或孕晚期转变为阴道微生态正常。(2)无症状性细菌性阴道病随着孕周增加部分可自然消退40%(2/5)。(3)H2O2阳性、阴道pH低者易从阴道微生态失调转为阴道微生态正常。结论妊娠期阴道微生态是动态变化的,部分细菌性阴道炎可自然消退,H2O2阳性及低阴道pH为维持正常阴道微生态的重要因素。Objective To describe the longitudinal variation of vaginal microecology in pregnancy. Method Vaginal swabs were obtained from 50 enrolled women who were healthy asymptomatic and in singleton pregnancy at average gestational age of （ 10.2 ± 2.1 ） weeks, （24.6 ± 3.7 ） weeks, and （33.2 ± 3.4） weeks, respectively. The vaginal secretions were exam- ined in terms of the pH value, the hydrogen peroxide test, bacterial culture, and Gram dyeing inspection of vaginal bacteria and microecology appraisal for colony＇s density, the multiplicity, predominant fungus, and the inflammatory response. Result （1） 38 women had normal vaginal microecosystem during the first trimester, of which 31 （81.58%） maintained normal vagi- nal mieroeeosystem throughout pregnancy, 7 （18.42%） converted to abnormal vaginal microecosystem in the second or third trimester. Conversely, of the 12 women with abnormal vaginal microecosystem in the first trimester, 6 （50%） reconverted to normal vaginal microecosystem in the second or third trimester. （2） As the pregnancy progressed, almost 40% of untreated women in our study had spontaneous regression of asymptomatic bacterial vaginosis. （ 3 ） Women with positive hydrogen perox- ide and low acidity predisposed to convert from abnormal vaginal microecosystem to normal vaginal mieroecosystem. Conclusion The vaginal microeeosystem of healthy asymptomatic pregnant women change dynamically. Some bacterial vaginosis can regress spontaneously. To maintain the normal vaginal microecosystem, it is very important to keep positive hydrogen peroxide and low acidity.

关 键 词：阴道微生态 妊娠 纵向研究 

分 类 号：R714.1[医药卫生—妇产科学]