双重荧光染色在妇科阴道炎诊断中的应用价值  

Application value of double fluorescence staining method in the diagnosis of gynecological vaginitis

作　　者：李翠[1] 段忠亮[1] 应春妹[1] LI Cui;DUAN Zhong-Liang;YING Chun-Mei(Obstetrics and Gynecology Hospital of Fudan University,Shanghai,200011,China)

机构地区：[1]复旦大学附属妇产科医院,上海200011

出　　处：《中国妇幼保健》2022年第15期2734-2737,共4页Maternal and Child Health Care of China

基　　金：国家自然科学基金面上项目(81873970)。

摘　　要：目的 探讨双重荧光染色系统在妇科门诊患者阴道分泌物常规检测中的应用价值。方法 收集2020年12月—2021年5月复旦大学附属妇产科医院黄浦分院妇科门诊检查阴道炎的患者标本,同时采用传统的湿片镜检法和双重荧光染色法对患者阴道分泌物进行检测分析,比较双重荧光染色法的优势。依据显微镜下形态,报告孢子、假菌丝、线索细胞、滴虫、脓细胞及杂菌等检测项目;并用配对χ^(2)检验分析该染色系统与传统显微镜湿片镜检法的一致性和差异。结果 从结果的保存和展示的角度分析,双重荧光染色法可将每位患者的结果分析表现为文字报告的同时,以图片的形式体现在检查报告中,便于直观判断,也便于结果回溯,明显优于传统的湿片镜检法。从结果的阳性率和两种方法的一致性分析,5 625例阴道炎患者中,双重荧光染色法显示菌群失调病例694例,占12.3%,显著高于湿片镜检法的315例,差异有统计学意义(χ^(2)=351.200,P<0.001),一致性一般;念珠菌性阴道炎(含孢子和假菌丝)1 490例,占26.5%,显著优于湿片镜检法的1 226例,差异有统计学意义(χ^(2)=245.408,P<0.001),一致性较好;细菌性阴道炎病例1 602例,占28.5%,显著优于湿片镜检法的1 017例,差异有统计学意义(χ^(2)=575.168,P<0.001),一致性一般;滴虫性阴道炎76例,占1.4%,与湿片镜检法的73例比较,差异无统计学意义(χ^(2)=0.800,P>0.05),一致性较好;非特异性阴道炎2 012例,占35.8%,与湿片镜检法的2 004例比较,差异无统计学意义(χ^(2)=8.167,P>0.05),一致性较好。结论 双重荧光染色法容易保存结果,且可清晰显示致病菌和患者阴道分泌物菌群分布情况,优于传统湿片镜检法;双重荧光染色系统作为一项新技术,可提高妇科阴道炎患者阴道疾病检出率,值得在妇科门诊中应用推广。Objective To explore the application value of double fluorescence staining method in routine detection of vaginal secretions in gynecological outpatients.Methods Patients with vaginitis were collected from the Huangpu Branch of the Obstetrics and Gynecology Hospital of Fudan University from December 2020 to May 2021, and the vaginal secretions of the patients were detected and analyzed by traditional wet film microscopic method and double fluorescence staining method. According to the morphological report of spores, mycelium, clue cells, trichomonas, pus cells, miscellaneous bacteria and other detection items under the microscope, the McNemar-Bowker test was used to analyze the consistency and difference of this staining system compared with the traditional wet film microscopic method.Results From the perspective of the preservation and display of the results, the double fluorescence staining method can analyze the results of each patient in the text report at the same time, and reflect it in the examination report in the form of pictures, which was convenient for intuitive judgment and the backtracking of the results, which was obviously better than the traditional wet film microscopy method. From the positive rate of the results and the consistency analysis of the two methods, among the 5 625 cases of vaginal samples, there were 694 cases of flora disorder, accounting for 12.3%, which were significantly higher than 315 cases by wet film microscopic method(χ^(2)=351.200, P<0.001);Candida vaginitis(including spores and mycelium) were 1 490 cases, accounting for 26.5%, which showed superior to wet film microscopic method(χ^(2)=245.408, P<0.001), with good consistency;1 602 cases of bacterial vaginitis, accounting for 28.5%, significantly better than 1 017 cases by wet film microscopic method(χ^(2)=575.168, P<0.001);76 cases of dripper vaginitis were found, accounting for 1.4%, with 73 cases by wet film microscopic method, no significant difference(χ^(2)=0.800, P> 0.05);non-specific vaginitis were 2 012 cases,

关 键 词：双重荧光染色 传统湿片镜检法 阴道炎 

分 类 号：R711[医药卫生—妇产科学]