阴道分泌物清洁度亚级别的建立及分级标准的探讨  

The sublevel of cleanliness of vaginal discharge and grading standards

作　　者：王晓娜[1] 李康怡 王岩[1] 佟成龙 曹东华[2] 丛桂敏 

机构地区：[1]沈阳市妇婴医院检验科,辽宁沈阳110011 [2]中国人民解放军第202医院优生优育中心,辽宁沈阳110005

出　　处：《中国微生态学杂志》2015年第10期1214-1217,共4页Chinese Journal of Microecology

摘　　要：目的探讨阴道分泌物清洁度亚级别的建立及划分标准,为阴道病的诊断治疗提供更可靠依据。方法采用革兰染色法,对沈阳市妇婴医院妇科门诊15 000例女性阴道分泌物涂片检查结果及阴道微生态系统进行分析,比较不同年龄组患者阴道分泌物病原菌检出的种类及感染率差异,对比感染与清洁度的相关性。结果 〉55岁年龄组未检出任何细菌的全阴性检出率为15.10%,高于其他年龄组（P〈0.05）。〉20~40岁年龄组滴虫检出率为11.00%,高于〉4~20年龄组（0.90%）和〉55岁年龄组（1.20%）,组间比较差异有统计学意义（P〈0.05）。〉20~40岁年龄组真菌检出率32.20%,高于〉55岁以上年龄组（14.70%）,组间比较差异有统计学意义（P〈0.05）。〉40~55岁年龄组的线索细胞检出率27.60%,高于〉55岁年龄组（0.75%）,组间比较差异有统计学意义（P〈0.05）。纤毛菌检出率在所有组别中差异均无统计学意义（P〉0.05）。将传统清洁度中Ⅱ、Ⅲ、Ⅳ度分别进行更详细的亚级别的划分。结论阴道分泌物清洁度划分应综合考虑受检者的激素状态、治疗状态等个体差异。详细的清洁度划分标准可为临床医师提供更准确的检验信息和指导合理治疗。Objective To discuss the establishment of sublevel of vaginal discharge cleanliness and the grading standards, and provide a more reliable basis for clinical diagnosis. Methords Gram staining was used to check 15 000 smears and analyze the vaginal micro-ecosystem; the type of pathogenic bacteria and detection rate were compared among different age groups to explore the relationship between infections and cleanli- ness. Results 15.1% of the specimens in 〉55 age group were negative of all pathogens, significantly high- er than in the other groups （P〈0.05）. The detection rate of Trichomonad in 〉20 - 40 age group （11. 00%） was significantly higher than those in 〉4 -20 age group （0. 90%） and 〉55 age group （20%） （P〈 0.05）. The detection rate of Fungi in 〉20 - 40 age group （2.20%） was higher than that in 〉55 age group （14.70%） with statistical significance （P〈0.05）. The detection rate of clue cells in 〉20 - 40 age group （27. 60%） was significanly higher than that in 〉55 age group （0.75%） （P〈0.05）. There were no statisti cally significant differences in the detection rates of Leptotrichia among each groups （P〉0.05）. The con- ventional cleanliness II, III and IV could be divided into 4 subdegrees respectively. Conclusion The classifi- cation of vaginal cleanliness should be based on multiple factors such as hormone, treatment and individual differences, etc. More detailed standard for vaginal discharge cleanliness can provide clinicians with accurate information and guidance for reasonable treatment.

关 键 词：阴道分泌物清洁度 阴道微生态 病原菌 线索细胞 

分 类 号：R446.1[医药卫生—诊断学]