无症状性BV的自然转归及其高危因素分析  

Natural history of asymptomatic bacterial vaginosis and the risk factors for its outcome

作　　者：张瑞[1] 桑佳特[2] 吴文湘[1] 那日苏[1] 牛小溪 廖秦平 

机构地区：[1]北京大学第一医院北京100034 [2]天津医科大学总医院,天津300050 [3]清华长庚医院,北京102218

出　　处：《现代妇产科进展》2015年第12期881-884,共4页Progress in Obstetrics and Gynecology

基　　金：国家自然科学基金资助项目(No:81170535;No:81471420)

摘　　要：目的：研究无症状性细菌性阴道病（BV）患者的自然转归情况,分析可能影响自然转归的高危因素。方法：从体检中心选取未治疗的无症状性BV患者160例,跟踪观察4个月,记录每例患者的病例特点及最终结局。单变量分析及多变量分析各种因素与结局之间的相关性。结果：160例患者中,41%病情进展,53%病情无明显变化,6%病情自行好转。病情进展的患者中,38%变为有症状的BV,24%变为BV合并VVC。单变量分析发现,经常出差（OR 3.72,95%CI 1.85-7.46）、BV病史（OR 4.78,95%CI 2.42-9.44）与患者病情进展有关。安全套避孕（OR=0.46,95%CI 0.24-0.90）、Nugent评分较低（OR=0.40,95%CI 0.21-0.79）对无症状BV有保护作用。多变量分析发现,安全套避孕对患者有保护作用,BV病史和经常出差是病情进展的高危因素。结论：对无症状性BV患者进行干预是必要的。Objective ： To evaluate the natural history of asymptomatic bacterial vaginosis and analyze the risk factors which may affect the outcome. Methods：Volunteer women who were diagnosed as asymptomatic bacterial vaginosis and refused to accept treatment were recruited for this study. During the four months, the characteristics of all the women were recorded and the outcomes of the disease were assessed in the end of four months. Univariate analysis and multivariate analysis were used to analyze the risk factors. Results： 160 volunteer women were recruited in the study. In the end of four months,41% of the patients became more serious than before. 53% of the patient were stable, and only 6% of them became spontaneous healing. In the patients who became more serious than before,38% became symptomatic BV and others became mixed infection. Univariate analysis indicated that always travelling （ OR 3.72,95 % CI 1.85 - 7.46 ）, and history of BV （ OR 4.78,95 % CI 2.42 - 9.44） were related to the progress of the disease. Use of condom （ OR O. 46,95 % CI 0. 24 - 0.90） and lower Nugent score （ OR 0.40,95% CI 0. 21 - 0.79 ） were beneficial to the patients. Multivariate analysis found that his- tory of BV and always travelling were high risk factor for the progress of the disease, and use of condom was beneficial to patients. Conclusions：It was necessary to manage these asymptomatic bacterial vaginosis.

关 键 词：无症状性细菌性阴道病 自然转归 高危因素 阴道乳杆菌 阴道微生态 

分 类 号：R711.31[医药卫生—妇产科学]