阴道混合感染患者阴道微生态分析  

Vaginal microbiological analysis of mixed vaginal infection

作　　者：段文冰[1] 刘芸[1] 鞠瑛[1] 刘义庆[1] 张璐璐[1] 李晓莹[1] 赵万辉[1] 张炳昌[1] Duan Wenbing;Liu Yun;Ju Ying;Liu Yiqing;Zhang Lulu;Li Xiaoying;Zhao Wanhui;Zhang Bingchang(Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China)

机构地区：[1]山东大学附属省立医院临床医学检验部,济南250021

出　　处：《中国医药》2018年第2期257-261,共5页China Medicine

基　　金：山东省自然科学基金(ZR2016HM52);山东省科学技术发展计划(2014GGH218041);山东省临床重点专科建设项目(鲁卫医字2013-26)~~

摘　　要：目的探讨女性阴道混合感染的微生态状况。方法选取2016年6-12月就诊于山东大学附属省立医院妇科的患者1 106例,分别采集患者阴道分泌物,通过相差显微镜和革兰染色进行患者阴道清洁度、需氧菌阴道炎(AV)评分、Nugent评分及功能评价等阴道微生态检测。结果①1 106例患者中单一感染694例(62.8%),混合感染412例(37.2%),混合感染组与单一感染组阴道清洁度、pH值、菌群密集度、菌群多样性、过氧化氢、白细胞酯酶、唾液酸苷酶、AV评分比较,差异均有统计学意义(X^2=255.44、45.77、28.21、188.05、17.00、19.78、85.43、46.00,均P<0.01)。②AV单一感染者占所有单一感染患者的42.6%(296/694),AV混合感染者占所有混合感染患者的98.1%(404/412)。AV单一感染者中有细菌性阴道病(BV)倾向的患者占67.6%(200/296),AV混合感染者中AV+BV者占40.6%(164/404),AV+假丝酵母菌病者占35.6%(144/404)。③AV混合感染组与AV单一感染组AV严重程度[轻度AV:50.2%(203/404)比67.2%(199/296),中度AV:31.2%(126/404)比26.7%(79/296),重度AV:18.6%(75/404)比6.1%(18/296)]比较差异有统计学意义(x^2=20.15,P<0.01)。结论女性阴道混合感染中AV混合感染发生率高,且极易合并其他感染,阴道微生态评价为临床的感染评估、诊断和及时治疗提供了依据。Objective To analyze the microbiological characteristics of mixed vaginal infection. Methods A total of 1 106 cases of gynecological inflammation were enrolled from June to December 2016 in Provincial Hospital Affiliated to Shandong University. Vaginal secretions were separated from these patients. Vaginal cleanness, aerobic vaginitis（AV） score and Nugent score were assessed by phase-contrast microscopy and Gram staining. Results There were 694 cases（62.8%） of single infection and 412 cases（37.2%） of mixed infection. Vaginal cleanliness, pH value, flora density and diversity, hydrogen peroxide, leukocyte esterase, neuraminidase and AV score showed significant differences between single infection and mixed infection patients（χ2=255.44, 45.77, 28.21, 188.05, 17.00, 19.78, 85.43, 46.00; all P〈0.01）. AV accounted for 42.6%（296/694） in patients with single infection, and it accounted for 98.1%（404/412） in patients with mixed infection. In single AV patients, 67.6%（200/296） patients were suspected of having bacterial vaginosis（BV）. In mixed AV patients, AV＋BV accounted for 40.6%（164/404）, AV＋candidiasis accounted for 35.6%（144/404）. The severity of AV showed a significant differences between mixed AV and single AV patients［mild AV： 50.2%（203/404） vs 67.2%（199/296）， moderate AV： 31.2%（126/404） vs 26.7%（79/296）， severe AV： 18.6%（75/404） vs 6.1%（18/296）］（χ2=20.15, P〈0.01）. Conclusion There is a high rate of AV infection in female mixed vaginal infection.

关 键 词：阴道感染 微生态 阴道 需氧菌阴道炎 

分 类 号：R711.3[医药卫生—妇产科学]