甲硝唑凝胶联合益生菌治疗孕早期细菌性阴道炎的疗效及对妊娠结局的影响  

Effect of metronidazole gel combined with probiotics in the treatment of bacterial vaginitis in early pregnancy and its effect on pregnancy outcome

作　　者：蓝丽萍[1] 廖世雄[1] 刘小慧 LAN Li-ping;LIAO Shi-xiong;LIU Xiao-hui(Department of Pharmacy,Huizhou Central People's Hospital,Huizhou 516001,Guangdong,CHINA;Department of Obstetrics,Huizhou Central People's Hospital,Huizhou 516001,Guangdong,CHINA)

机构地区：[1]惠州市中心人民医院药学部,广东惠州516001 [2]惠州市中心人民医院产科,广东惠州516001

出　　处：《海南医学》2022年第5期581-584,共4页Hainan Medical Journal

基　　金：广东省惠州市科技专项项目(编号:2021WC0106379)。

摘　　要：目的探讨甲硝唑凝胶联合益生菌治疗孕早期细菌性阴道炎的疗效及对妊娠结局的影响。方法回顾性分析2018年1月至2019年12月惠州市中心人民医院收治的130例孕早期合并细菌性阴道炎患者的临床资料。根据治疗方案的不同,将55例益生菌治疗者纳入益生菌组,75例甲硝唑凝胶联合益生菌治疗者纳入联合治疗组,比较两组患者治疗前后阴道pH值、阴道分泌物Nugent评分以及阴道灌洗液白细胞介素-6(IL-6)和白细胞介素-8(IL-8)水平,比较治疗效果及妊娠结局情况。结果两组患者治疗前的阴道pH值、阴道分泌物Nugent评分、阴道灌洗液IL-6和IL-8水平比较差异均无统计学意义(P>0.05);治疗后,两组患者的阴道pH值及阴道分泌物Nugent评分明显低于治疗前,且联合治疗组患者的上述指标分别为3.92±0.19、(3.89±0.21)分,明显低于益生菌组的4.29±0.28、(4.46±0.35)分,差异均有统计学意义(P<0.05);治疗后两组患者的阴道灌洗液IL-6、IL-8水平明显低于治疗前,且联合治疗组患者的上述指标分别为(5.33±0.84)pg/mL、(1.23±0.28)pg/mL,明显低于益生菌组的(10.02±1.89)pg/mL、(2.87±0.46)pg/mL,差异均有统计学意义(P<0.05);联合治疗组患者的治疗总有效率为97.33%,明显高于益生菌组的85.45%,差异有统计学意义(P<0.05);联合治疗组患者的不良妊娠结局发生率为10.67%,明显低于益生菌组的23.64%,差异有统计学意义(P<0.05)。结论甲硝唑凝胶联合益生菌制剂治疗孕早期细菌性阴道炎能够有效改善患者阴道微生态环境和炎症反应,降低不良妊娠发生风险,疗效确切,值得临床推广应用。Objective To explore the efficacy of metronidazole gel combined with probiotics in the treatment of bacterial vaginitis in early pregnancy and its effect on pregnancy outcome.Methods The clinical data of 130 patients with bacterial vaginitis in early pregnancy treated in Huizhou Central People's Hospital from January 2018 to December 2019 were analyzed retrospectively.According to the different treatment regimens,55 probiotics treated with probiotics were included in the probiotics group,and 75 patients treated with metronidazole gel combined with probiotics were included in the combined treatment group.The changes of vaginal pH value,Nugent score of vaginal secretion,and the levels of IL-6 and IL-8 in vaginal lavage fluid were compared between the two groups before and after treatment.The therapeutic effect and pregnancy outcome of the two groups were compared.Results There was no significant difference between the two groups in vaginal pH value,Nugent score of vaginal secretion,and the levels of IL-6 and IL-8 in vaginal lavage fluid before treatment(P>0.05).After treatment,the vaginal pH value and Nugent score of vaginal secretion in the two groups were significantly lower than those before treatment,and the above indexes in the combined treatment group were 3.92±0.19 and(3.89±0.21)points,respectively,which were significantly lower than 4.29±0.28 and(4.46±0.35)points in the probiotic group(P<0.05).After treatment,the levels of IL-6 and IL-8 in vaginal lavage fluid in the two groups were significantly lower than those before treatment,and the above indexes in the combined treatment group were(5.33±0.84)pg/mL and(1.23±0.28)pg/mL,respectively,which were significantly lower than(10.02±1.89)pg/mL and(2.87±0.46)pg/mL in the probiotic group(P<0.05).The total effective rate of the combined treatment group was 97.33%,which was significantly higher than 85.45%in the probiotic group(P<0.05).The incidence of adverse pregnancy outcomes in the combined treatment group was 10.67%,which was significantly lower than 23.

关 键 词：细菌性阴道炎 妊娠早期 甲硝唑凝胶 益生菌 疗效 妊娠结局 

分 类 号：R711.31[医药卫生—妇产科学]