阴道分泌物干化学法检测在常见阴道疾病诊断中的应用  

Application of dry chemical test for vaginal secretion determination in the diagnosis of common vaginal diseases

作　　者：焦瑞宝[1] 陈然[1] 周佳丽[1] 刘娜[1] 章文[1] 唐吉斌[1] JIAO Ruibao;CHEN Ran;ZHOU Jiali;LIU Na;ZHANG Wen;TANG Jibin(Department of Clinical Laboratory,Tongling People's Hospital of Anhui Province,Tongling 244009,Anhui,China)

机构地区：[1]铜陵市人民医院临床检验中心,安徽铜陵244009

出　　处：《检验医学》2018年第9期811-814,共4页Laboratory Medicine

摘　　要：目的探讨阴道分泌物干化学法检测在常见阴道疾病诊断中的应用。方法选取初诊阴道炎患者1800例,采用干化学法检测阴道分泌物5种酶学指标[脯氨酸氨基肽酶(PIP)、唾液酸苷酶(SNA)、凝固酶(COA)、乙酰氨基葡萄糖苷酶(NAG)和葡萄糖苷酶(GUS)],并同时进行阴道分泌物涂片革兰染色镜检。结果以革兰染色镜检法结果为标准,干化学法在细菌性阴道病(BV)、外阴阴道假丝酵母菌病和滴虫性阴道炎诊断中的敏感性分别为45.39%、44.68%和92.31%,特异性分别为97.14%、85.70%和96.20%;阳性预测值分别为88.18%、36.73%和34.95%,阴性预测值分别为79.12%、89.29%和99.82%;符合率分别为80.61%、79.28%和96.11%,不符合率分别为19.39%、20.72%和3.89%。1 800例患者阴道分泌物干化学法检测BV的阳性率低于革兰染色镜检法(χ2=515.24,P<0.001);干化学法检测外阴阴道假丝酵母菌病、滴虫性阴道炎的阳性率均高于革兰染色镜检法(χ2值分别为142.36、537.70,P<0.001)。结论目前尚不能用干化学法完全替代革兰染色镜检法,需充分利用2种方法的各自优势,以提高临床检测结果的准确性。Objective To investigate the role of dry chemical test for vaginal secretion determination in the diagnosis of common vaginal diseases.Methods A total of 1 800 patients diagnosed as vaginitis were enrolled.Using dry chemical test,vaginal secretions were determined for 5 kinds of enzymes,including proline iminopeptidase(PIP),saliva neuraminidase(SNA),coagulase(COA),N-acetylglucosaminidase(NAG)and glucosidase(GUS).Vaginal secretion smear Gram staining microscopy was performed simultaneously.Results The results of vaginal secretion smear Gram staining microscopy were used as standard.The sensitivities of dry chemical test for bacterial vaginosis(BV),vulvovaginal candidiasis and trichomonas vaginitis were 45.39%,44.68%and 92.31%,and the specificities were 97.14%,85.70%and 96.20%,respectively.The positive predictive values were 88.18%,36.73%and 34.95%,and the negative predictive values were 79.12%,89.29%and 99.82%,respectively.The consistency rates were 80.61%,79.28%and 96.11%,and the inconsistency rates were 19.39%,20.72%and 3.89%,respectively.The positive rate of BV for 1 800 cases of vaginal secretions by dry chemical test was lower than that by vaginal secretion smear Gram staining microscopy(χ2=515.24,P<0.001).The positive rates of vulvovaginal candidiasis and trichomonas vaginitis by dry chemical test were higher than those by vaginal secretion smear Gram staining microscopy(χ2=142.36 and 537.70,P<0.001).Conclusions Dry chemical test can not replace vaginal secretion smear Gram staining microscopy.It should make full use of 2 methods'advantages to improve the accuaracy of determination results.

关 键 词：干化学法 革兰染色镜检法 细菌性阴道病 外阴阴道假丝酵母菌病 滴虫性阴道炎 

分 类 号：R446.1[医药卫生—诊断学]