不同年龄段妇女阴道微生态状况分析  

Distribution and categories of pathogens causing vaginitis in different ages with vagina microenvironment determination

作　　者：曹敬荣[1] 王培昌[1] 闵嵘[1] 张丽丽[1] 王育英[1] 谢威[1] 段园园[1] 

机构地区：[1]首都医科大学宣武医院检验科,北京100053

出　　处：《中华实验和临床感染病杂志（电子版）》2016年第3期311-314,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的分析不同年龄段女性阴道微生态构成及微生态失调的病原分布,为阴道感染性疾病的病原学诊断和治疗提供实验室依据。方法回顾性分析本院2013年7月至2014年2月妇科门诊就诊的4 714例患者,按年龄分为6组（组距10岁）,取患者阴道分泌物进行革兰染色、Nugent评分、功能评价等阴道微生态检测,分析各年龄段阴道微生态状况与病原间的相关性。结果 4 714例患者中微生态正常者842例（17.86%）;阴道微生态失调者3 872例（82.14%）中菌群抑制474例（10.06%）,优势菌群异常138例（2.93%）,菌群正常但阴道p H值、乳酸杆菌功能异常者1 294例（27.45%）;单纯性阴道感染者1 654例（35.09%）,包括细菌性阴道病（BV）564例（11.96%）、BV中间型214例（4.54%）,阴道假丝酵母菌病（VVC）658例（13.96%）,滴虫性阴道炎（TV）12例（0.25%）,单纯性需氧性阴道炎（AV）206例（4.37%）;混合性阴道炎（MCVI）298例（6.32%）中主要为BV/BV中间型＋VVC 156例（3.30%）,其次是AV＋VVC 74例（1.57%）。阴道微生态失调者年龄集中于21-30岁组（36.57%）,31-40岁组（29.87%）和41-50岁组（16.63%）三组;混合性阴道炎、BV/BV中间型和VVC主要集中于21-30岁组（2.46%、4.62%和6.41%）和31-40岁组（1.87%、4.67%和5.01%）。随年龄增加及阴道微生态失调,阴道p H、Nugent评分和乳酸杆菌密集度变化显著（χ^2 =8.45、28.53、4.55,P=0.02、0.005、0.04）。结论育龄女性阴道感染发病率高,阴道p H和乳酸杆菌密集度与患者年龄及感染状况相关,应重视各年龄段女性阴道微生态检测。Objective To analyze the vaginal microecology of different age-groups, and to provide the evidence for the etiological diagnosis and treatment of vagina infection. Methods Total of 4 714 patients admitted to our hospital from July 2013 to February 2014 were divided into 6 groups（10 years old for group interval）. Vulvovaginal secretions were examined with Gram stain examination of vaginal discharge and assessed microecology by Nugent score, dominant bacteria to analyze the relationship of vaginal microecology and pathogeny. Results The abnormal vaginal microecology rate was 17.86%（842/4 714）, the disorder rate was 82.14%（3 872/4 714）. Among the disorder, the bacterial vaginosis constituent ratio was 11.96%（564/4 714）, the vulvovaginal candidiasis ratio was 13.96%（658/4 714）, the BV intermediate was 4.54%（214/4 714）, the triehomonas vaginitis constituent ratio was 0.25%（12/4 714）, the aerobic vaginitis was 4.37%（206/4 714） and mixed vaginitis was 6.32%（298/4 714）, other abnormal microflora was 12.99% including dominant bacteria changed or disappeared. The 21-30 years old group（36.57%）, 31-40 years old group（29.87%） and 41-50 years old group（16.63%） were the main groups of vaginal microecology disorder, and 21-30 years old group and 31-40 years old group were the main age distribution of the mixed vaginitis, BV/BV intermediate and VVC. With the increase of age, the p H, Nugent score and the density of Laetobacillus changed significantly（χ^2 = 8.45, 28.53, 4.55; P = 0.02, 0.005, 0.04）. Conclusions High incidence of vagina infection in women of childbearing age. The vagina p H, density of Laetobacillus were closely related to age and infection, so the vaginal microecology tests of different age groups should be paied attention to.

关 键 词：阴道微生态 年龄 失调 细菌性阴道病 外阴阴道假丝酵母菌病 混合性阴道炎 

分 类 号：R711.3[医药卫生—妇产科学]