妊娠合并需氧菌性阴道炎的微生态特征和围产结局分析  

Microecological characteristics and perinatal outcomes of pregnant women with aerobic vaginitis

作　　者：杨新民[1] 潘明香[2] 林琳[1] 

机构地区：[1]广东医学院附属南山医院产科,广东深圳518052 [2]深圳市宝安区妇幼保健院产科,广东深圳518100

出　　处：《中国微生态学杂志》2017年第4期465-468,共4页Chinese Journal of Microecology

基　　金：深圳市卫生科技项目(201303184)

摘　　要：目的探讨妊娠合并需氧菌性阴道炎(aerobic vaginitis,AV)的微生态特征和围产结局。方法选取AV孕妇120例为研究对象,并与同期正常孕妇100例作对照,取阴道分泌物行湿片、涂片染色、细菌培养及检测IL-6、IL-8,回顾性分析其病原菌菌群的分布,局部IL-6、IL-8水平及其对妊娠结局的影响。结果 120例妊娠合并AV主要致病菌是:大肠埃希菌45例(37.50%)、B族链球菌34例(28.33%)、粪肠球菌20例(16.67%)、金黄色葡萄球菌12例(10.00%),这四种细菌占致病菌总数的84.17%;与正常孕妇相比,AV组孕妇胎膜早破、产褥感染、新生儿感染发生率明显升高,分别是25.00%vs 11.00%(P<0.01)、12.50%vs 4.00%(P<0.05)、10.83%vs 3.00%(P<0.05),差异有统计学意义;而两组孕妇绒毛膜炎和早产发生率分别为8.30%vs 3.00%(P>0.05)、10.83%vs9.00%(P>0.05),差异无统计学意义;AV孕妇阴道分泌物中IL-6、IL-8表达的水平均明显高于正常组[(17.64±4.53)ng/Lvs(13.54±4.39)ng/L,P<0.001;(38.08±6.29)ng/L vs(27.34±5.10)ng/L,P<0.001]。结论孕期AV由肠源性细菌引起,可导致不良的围产结局,需要及时处理。Abstract： Objective To discuss the microecological characteristics and perinatal outcomes of pregnant women with aerobic vaginitis （AV） . Methods 120 late-pregnancy women with AV （AV group） and 100 healthy late-pregnancy women （control group） were selected. High vaginal swabs were collected; Vaginal wet mount, Gram staining and bacterial cultivation were performed; The levels of IL-6 and IL-8 were detec- ted with ELISA. The distribution of vaginal flora and perinatal outcomes were retrospectively analyzed. Results Among the 120 cases of pregnancy with AV, the most common pathogen was Escherichia coli （37.5 % ）, followed by group B Streptococcus （28.3 %）, Enterococcus faecalis （16.67 % ） and Staphylococ- cus aureus （10.00%） . The four pathogens accounted for 84.17% of abnormal dominant flora. The inci- dence rates of premature rupture of membranes （25.00% vs 11.00%, P〈0.01）, puerperal infection （12.50% vs 4.00~, P%O. 05） and neonatal infection （10.83% vs 3.00%, P〈O. 05） in AV group were significantly higher than those in control group. 10 vs 3 cases of chorioamnionitis and 13 vs 9 cases of prema- ture labor occurred in the AV group and control group respectively, with no significant differences （P〈 0.05） . The levels of IL-6 and IL-8 in vaginal secretion in AV group were statistically higher than those in the control group [- （17.64±4.53） ng/L vs （13.54±4.39） ng/L, P〈0. 001; （38.08±6.29） ng/L vs （27.34±5.10） ng/L, P%0. 0011 . Conclusion AV in pregnancy is caused by abnormal vaginal flora, which can lead to adverse perinatal outcomes and thus needs prompt clinical intervention.

关 键 词：需氧菌性阴道炎 微生态评价 围产结局 

分 类 号：R713[医药卫生—妇产科学]