细菌性阴道病经Amsel、Nugent指导治疗后的远期复发率比较  

Long-term recurrence rate of Bacterial Vagiosis treated under the guidance of Amsel vs. Nugent

作　　者：李桂军[1] 蒋琰瑛[2] 周建娟 蔡文伟[1] 

机构地区：[1]嘉兴市妇幼保健院检验科,浙江嘉兴314001 [2]嘉兴市妇幼保健院妇科,浙江嘉兴314001

出　　处：《中国微生态学杂志》2012年第12期1125-1127,1133,共4页Chinese Journal of Microecology

基　　金：嘉兴市科技局计划项目(2011AY1054-1)

摘　　要：目的比较细菌性阴道病(BV)经Amsel、Nugent指导治疗停药后的远期复发率差异。方法 201例BV患者被分成A(62例)、B(59例)、C(80例)三组。三组在治疗、随访过程中同时进行Amsel、Nugent评分检测共1 011例。A组治疗至临床症状消失、Amsel正常、Nugent评分≤3分、真菌和滴虫阴性时停药;B组治疗至临床症状消失、Amsel正常、Nugent评分4～6分、真菌和滴虫阴性时停药;C组治疗至临床症状消失、Amsel正常、真菌和滴虫阴性时停药。三组停药后均随访3个月,并用Amsel法评价BV停药后远期治疗效果。统计分析Amsel、Nugent评分法诊断BV一致性,分析三组BV、RBV患者停药随访3个月BV复发率差异。结果 Amsel、Nugent评分检测BV阳性率分别为27.79%和33.04%,二者差异有统计学意义。停药随访3个月时B组复发率为42.37%,C组为46.25%,但A组仅为16.13%,A组与B、C两组差异有统计学意义。停药随访3个月,三组BV患者复发率均较低且差异无统计学意义,但对三组RBV患者而言,停药随访3个月时,C组全部复发,B组复发率为85.00%,但A组仅为28.57%。A组与B组、C组两组差异有统计学意义。结论与Amsel方法相比,Nugent评分能更好的指导BV后续治疗。BV患者治疗至Nugent评分≤3分且临床症状消失再停止治疗,可明显降低BV远期复发率,但对于治疗至Nugent评分4～6分且临床症状消失BV患者,为减少远期复发率,应进一步治疗和随访。Objective To compare the long-term recurrence rates of Bacterial Vagiosis（BV） treated under the guidance of Amsel and Nugent.Methods 201 BV patients were randomly assigned to Group A（disappearance of clinical symptoms,normal Amsel,Nugent ≤ 3,and negative fungi and infusorian as the endpoint of treatment）,Group B（disappearance of clinical symptoms,normal Amsel,Nugent 4-6,and negative fungi and infusorian as the endpoint of treatment）,and Group C（disappearance of clinical symptoms,normal Amsel,and negative fungi and infusorian as the endpoint of treatment）.Recurrence rates of the three groups were observed during 3 months of follow-up period.Diagnostic concordance of Amsel and Nugent was analyzed.Results The percentages of BV diagnosed by Amsel and Nugent were 27.79% and 33.04% respectively,with significant difference.BV recurrence rates of groups A,B and C were 16.13%,42.37% and 46.25% at the third follow-up month,respectively.There was no significant difference among BV patients in the three groups.However,the BV recurrence rates of RBV patients in groups A,B and C were 28.57%,85.00% and 100.00% at the third follow-up month,respectively.Conclusion Compared with Amsel,Nugent is preferable guidance for subsequent treatment.The long-term recurrence rate of BV and RBV Patients should be reduced effectively if their treatment continue until the clinical symptoms disappear with normal Amsel,Nugent ≤ 3,and negative fungi and infusorian.In order to reduce long-term recurrence rate,patients received individualized treatment to Nugent 4-6 and disappearance of clinical symptoms should be further treated and followed-up.

关 键 词：细菌性阴道病 复发 Nugent评分 Amsel检测 

分 类 号：R711.73[医药卫生—妇产科学]