人型支原体共生对甲硝唑临床治疗阴道毛滴虫感染的影响  

Mycoplasma hominis symbiosis and Trichomonas vaginalis metronidazole clinical treatment efficacy

作　　者：谢成彬[1] 王频佳[2] 吴雨露[1] 苏喆[1] 

机构地区：[1]四川省妇幼保健院检验科,成都610045 [2]成都医学院检验医学院,成都610500

出　　处：《现代妇产科进展》2013年第6期461-464,共4页Progress in Obstetrics and Gynecology

基　　金：四川省卫生厅科研课题(No:120493)

摘　　要：目的:研究人型支原体共生对甲硝唑治疗阴道毛滴虫感染患者临床效果的影响。方法:分离培养阴道毛滴虫并检测其甲硝唑最小致死浓度(MLC)。PCR检测滴虫细胞内人型支原体DNA,比较共生阴道毛滴虫株在人型支原体清除前后甲硝唑MLC的变化。将患者分为阴道毛滴虫单独感染组(滴虫组)与人型支原体共生感染组(共生组),比较甲硝唑对滴虫组与共生组患者进行标准治疗后的临床治疗效果。结果:(1)200株阴道毛滴虫的甲硝唑MLC为0.2～200μg/ml,其中132株(66.0%)低MLC虫株(≤6.3μg/ml)、45株(22.5%)中MLC虫株(12.5～25μg/ml)、23株(11.5%)高MLC虫株(50～200μg/ml);(2)76株(38.0%)阴道毛滴虫检出人型支原体共生,其中低、中、高MLC虫株共生率分别为12.9%(17/132)、84.4%(38/45)和91.3%(21/23),差异有统计学意义(P<0.01);(3)200例患者甲硝唑治疗的总有效率为82.0%,其中滴虫组与共生组总有效率分别为95.2%和60.5%,差异有统计学意义(P<0.01);低、中、高MLC共生组总有效率分别为76.5%、65.8%和38.1%,差异有统计学意义(P<0.05);(4)11株共生虫株经多西环素作用清除人型支原体后,其甲硝唑MLC基本无变化。结论:人型支原体共生可能与甲硝唑治疗阴道毛滴虫的临床效果有关,但未发现直接相关关系。Objective：To investigate the effect of Mycoplasma hominis symbiosis on Trichomonas vaginalis metronidazole clinical treatment efficacy.Methods：T.vaginalis isolates were collected and purified from clinical specimen and the metronidazole minimum lethal concentration（MLC） of these isolates was determined,M.hominis DNA in T.vaginalis was detected by polymerase chain reaction（PCR）.After clearance of M.hominis in T.vaginalis by doxycycline,MLC was determined and compared with that before clearance.These patients were categorized as T.vaginalis alone infection cases or Mycoplasma hominis symbiosis cases,and both categories of cases were managed according to a standard metronidazole regimen,treatment efficacy was compared and analyzed.Results：（1）Metronidazole MLC ranged from 0.2 to 200 μg/ml in 200 T.vaginalis isolates,consisting of 132 low MLC isolates（≤6.3μg/ml,66.0%）,45 medium MLC isolates（12.5~25μg/ml,22.5%） and 23 high MLC isolates（50~200μg/ml,11.5%）.（2）76 isolates were PCR positive（38.0%） for M.hominis DNA in T.vaginalis cell and identified as M.hominis symbiosis,and symbiosis rates of low MLC,medium MLC and high MLC isolates were 12.9%（17/132）,84.4%（38/45） and 91.3%（21/23）,respectively,and the difference was statistically significant（P〈0.01）.（3）The total clinical effective rate of metronidazole was 82.0% in 200 cases,and T.vaginalis alone infection cases and Mycoplasma hominis symbiosis cases were 95.2% and 60.5% respectively,and the difference was statistically significant（P〈0.01）,while low MLC,medium MLC and high MLC isolates were 76.5%,65.8% and 38.1% respectively,and the difference was statistically significant（P〈0.05）.（4）After treated with doxycycline,M.hominis was cleared from 11 symbiosis isolates,but no change in metronidazole MLC was observed from those isolates.Conclusions：M.hominis symbiosis maybe associated with T.vaginalis metronidazole clinical treatment efficacy,however,it don＇t directly correlate with in vitro re

关 键 词：人型支原体 阴道毛滴虫 甲硝唑 

分 类 号：R382.21[医药卫生—医学寄生虫学]