阴道菌群失调与PCOS病情程度及影响因素  

Analysis of the relationship between vaginal flora disorder and severity of PCOS,and the influencing factors of PCOS

作　　者：姜方清 苏春芳 秦丽 黄卫东 JIANG Fangqing;SU Chunfang;QIN Li;HUANG Weidong(The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei Province, 445000)

机构地区：[1]湖北省恩施土家族苗族自治州中心医院,445000

出　　处：《中国计划生育学杂志》2021年第9期1845-1848,1853,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨阴道菌群失调与多囊卵巢综合征(PCOS)病情关系及发病影响因素。方法:选择2017年5月—2020年4月本院收治的PCOS患者304例,根据患者有无排卵或稀发排卵(O)、雄激素水平(HA)、卵巢多囊样变化(P)等分成A组(O+HA+P,n=72)、B组(O+HA,n=85)、C组(HA+P,n=78)和D组(O+P,n=69);同期体检健康志愿者60例为对照组。所有患者均于月经干净7d后采集阴道分泌物,检测PH值、菌群密集度、菌群多样性等,分析病情严重程度与阴道菌群失调关系。logistic回归分析影响PCOS发病的独立影响因素。结果:5组菌群密度集、菌群多样性、优势菌、滴虫检出率和假丝酵母菌检出率以及PH值均无差异(P>0.05);清洁度(Ⅲ+Ⅳ)占比和阴道菌群失调率A组高于对照组(P<0.05)。logistic回归分析显示,阴道菌群失调(OR=2.234,95%CI:1.301~3.838)、月经周期紊乱(OR=2.038,95%CI:1.069~3.884)、负面情绪(OR=2.770,95%CI:2.238~3.430)和睡眠质量差(OR=2.482,95%CI:1.373~4.486)是PCOS发生的独立危险因素(P<0.05)。结论:阴道菌群失调与PCOS患者病情程度相关,阴道菌群失调、月经周期紊乱、负面情绪和睡眠质量差等是PCOS发病危险因素,临床宜针对上述因素行相应干预,以降低疾病发生率。Objective:To explore the relationship between the vaginal flora disorders of women with polycystic ovary syndrome(PCOS)and their severity of PCOS,and to study the influencing factors of PCOS.Methods:304 women with PCOS were selected from May 2017 to April 2020.And according to whether had ovulation or rare ovulation(O),the androgen(HA)level,or whether had polycystic changes of ovary(P),these women were divided into group A(72 women with O+HA+P),group B(85 women with O+HA),group C(78 women with HA+P),and group D(69 women with O+P).During the same period,60 healthy women were selected in control group.Vaginal secretions of all the women were collected after menstruation 7 days for detected the parameters of vaginal secretions,such as pH value,flora density,and flora diversity.The relationship between the severity of the PCOS of the women and their vaginal flora imbalance was analyzed.Logistic regression analysis was used to analyze the independent factors affecting the incidence of PCOS.Results:There were no significant differences in microflora density,microflora diversity,dominant bacteria,detection rates of trichomonas and candida,and PH value of the women among the five groups(P>0.05).The proportion of cleanliness(Ⅲ and Ⅳ)and the rate of maladjustment of vaginal microflora of the women had significant different among the five groups,and which of the women in group A were significant higher than of the women in the control group(P<0.05),but which of the women had no significant different among group A,B,C,and D(P>0.05).Logistic regression analysis showed that vaginal microflora disorder(OR=2.234,95%CI:1.301-3.838),menstrual cycle disorder(OR=2.038,95%CI:1.069-3.884),negative mood(OR=2.770,95%CI:2.238-3.430),and poor sleep quality(OR=2.482,95%CI:1.373-4.486)were the independent risk factors of PCOS(P<0.05).Conclusion:The imbalance of vaginal flora is related to the severity of PCOS.The vaginal flora disorder,menstrual cycle disorder,negative emotion,and poor sleep quality were the risk factors of PCOS,so clin

关 键 词：多囊卵巢综合征 阴道菌群失调 病情严重程度 发病影响因素 

分 类 号：R71[医药卫生—妇产科学]