妊娠合并细菌性阴道病感染特征及妊娠结局分析  

Clinical analysis of pregnancy complicated with bacterial vaginosis infection and the influence of pregnancy outcome

作　　者：齐亮[1] 唐晓磊[1] 赵锡桐 QI Liang;TANG Xiaolei;ZHAO Xitong(Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院,辽宁沈阳110004

出　　处：《中国病原生物学杂志》2023年第5期566-569,574,共5页Journal of Pathogen Biology

摘　　要：目的分析孕28周后孕晚期妊娠合并细菌性阴道病的发病率、感染特点及对妊娠结局的影响。方法选取2020年1月1日~2022年7月31日,孕28周后孕晚期于本院进行妊娠期细菌性阴道病筛查的孕产妇1566例为研究对象。采集患者阴道分泌物进行检测,使用Amsel临床诊断方法进行临床判断。同时观察分泌物中乳酸杆菌、阴道加德纳菌、其他细菌等密集度,并使用酶联免疫吸附测定法测定阴道分泌物中白细胞介素-8(IL-8)水平。征求315例妊娠合并细菌性阴道病孕产妇本人意愿,同意接受治疗者纳入治疗组(n=150),拒绝者纳入未治疗组(n=165)。选取同期健康孕产妇300例为健康对照组,比较不同分组间孕产妇的妊娠结局。结果315例孕妇合并细菌性阴道病,发病率为20.11%,霉菌性阴道炎发病率(14.43%)、滴虫性阴道炎发病率(0.51%)显著低于细菌性阴道病发病率。不同孕周细菌性阴道病的发病率不同,孕28~33+6周孕妇发病率为11.01%(49/446),孕34~39+6周孕妇发病率为25.65%(238/928),孕40~42周孕妇发病率为14.58%(28/192)。细菌性阴道病阳性组孕妇乳杆菌密集度主要集中于0~Ⅰ级(99.37%),阴道加德纳菌密集度主要集中于Ⅲ~Ⅳ级(80.95%),其他细菌密集度主要集中于Ⅰ~Ⅱ级(50.16%)。健康对照组孕妇乳杆菌密集度主要集中于Ⅱ~Ⅲ级(93.33%),阴道加德纳菌密集度主要集中于0~Ⅰ级(82.67%),其他细菌密集度主要集中于0~Ⅰ级(71.33%)。阳性组孕妇乳杆菌密集度0级占比高于对照组,Ⅱ级、Ⅲ级占比低于对照组,阴道加德纳菌密集度Ⅱ级、Ⅲ级、Ⅳ级占比高于对照组,其他细菌密集度0级占比低于对照组,Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级占比高于对照组,差异有统计学意义(均P<0.05)。阳性组孕妇的IL-8水平显著高于阴性组孕妇。阳性组孕产妇早产率、胎膜早破发生率、产褥感染发生率、新生儿窒息发生率、新生儿黄疸发生率、新生儿感染�Objective To analyze the incidence rate and infection characteristics of bacterial vaginosis in the third trimester of pregnancy after 28 weeks of pregnancy and its influence on the pregnancy outcome.Methods From January 1,2020 to July 31,2022,1566 pregnant women who were screened for bacterial vaginosis during pregnancy at our hospital in the third trimester after 28 weeks of pregnancy were selected as the study subjects.The vaginal secretions from patients were collected to detected,and the clinical judgment were judged by Amsel clinical diagnosis method.At the same time,lactobacillus,Gardner vaginalis and the density of other bacteria in vaginal secretions were observe.The level of interleukin-8(IL-8)in vaginal secretions were determined by enzyme-linked immunosorbent assay.The wishes of 315 pregnant women with bacterial vaginosis during pregnancy were solicited.Those who agreed to receive treatment were included in the treatment group(n=150),and those who refused to receive treatment were included in the non-treatment group(n=165).At the same time,300 healthy pregnant women in the same period were selected as the healthy control group,and the pregnancy outcomes of pregnant women in different groups were compared.Results 315 pregnant women complicated with bacterial vaginosis,the incidence rate was 20.11%.The incidence rate of fungal vaginitis(14.43%)and the incidence rate of trichomonal vaginitis(0.51%)were significantly lower than the incidence rate of bacterial vaginosis.The incidence rate of bacterial vaginosis varies in different gestational weeks.The incidence rate of pregnant women at 28-33+6weeks is 11.01%(49/446),the incidence rate of pregnant women at 34-39+6weeks is 25.65%(238/928),and the incidence rate of pregnant women at 40-42 weeks is 14.58%(28/192).The concentration of lactobacilli in pregnant women with positive bacterial vaginosis was mainly concentrated in grades 0 to Ⅰ(99.37%),the concentration of Gardner's bacteria in vagina was mainly concentrated in grades Ⅲ to Ⅳ(80.95%),and the c

关 键 词：妊娠 细菌性阴道病 妊娠结局 

分 类 号：R378[医药卫生—病原生物学]