妊娠期细菌性阴道病患者菌群特征及其与不良妊娠结局关系  

Vaginal flora characteristics of pregnant women with bacterial vaginosis and the correlation between the bacterial vaginosis of and pregnancy outcomes

作　　者：张彤[1] 李越[1] 张欣[1] 李贞贞 ZHANG Tong;LI Yue;ZHANG Xin;LI Zhenzhen(The Second Affiliated Hospital of XIAN Jiaotong University,Xi'an,Shanxi Province,71oo04)

机构地区：[1]西安交通大学第二附属医院,710004

出　　处：《中国计划生育学杂志》2024年第12期2872-2876,共5页Chinese Journal of Family Planning

摘　　要：目的:观察妊娠期细菌性阴道病的病原菌分布特征,并探析其与不良妊娠结局关系。方法:纳入2021年3月-2023年3月本院收治的妊娠合并细菌性阴道病患者936例临床资料,通过检测阴道分泌物,观察病原菌分布特征并探析与不良妊娠结局的关系。结果:936例中孕早期143例共检出细菌151株,孕中期329例共检出细菌342株,孕晚期464例共检出细菌512株;主要致病菌为加德纳菌、大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌;有86例发生不良妊娠,发生率为9.2%,其中早产76例、胎膜早破10例,分别检出163株、30株致病菌,早产以加德纳菌、大肠埃希菌和肺炎克雷伯菌为主,胎膜早破以加德纳菌、大肠埃希菌、铜绿假单胞菌为主;不良妊娠患者阴道加德纳菌、大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌密集度以Ⅲ、Ⅳ级分布为主,乳杆菌密集度以Ⅰ、Ⅱ级为主,与正常妊娠结局患者比较存在差异;不良妊娠结局与正常妊娠结局患者的阴道菌群的丰富度在孕早、中、晚期均存在差异,Shannon-Wiener指数在孕中、晚期存在差异(均P<0.05)。结论:妊娠期细菌性阴道病患者阴道菌群失衡较为普遍,发生早产、胎膜早破等不良妊娠结局患者阴道加德纳菌、大肠埃希菌等致病菌密集度和菌群多样性增加更明显。Objective:To observe the vaginal flora distribution characteristics of pregnant women with bacterial vaginosis,and to study the correlation between the bacterial vaginosis of the women and their pregnancy outcomes.Methods:The clinical data of 936 pregnant women with bacterial vaginosis in the hospital from March 2021 to March 2023 were included in this study.The distribution characteristics of vaginal pathogenic bacteria of the women were observed by detecting their vaginal secretions.,The correlation between the distribution characteristics of the vaginal pathogenic bacteria of the women and their pregnancy outcomes was analyzed.Results:Among 936 women,151 strains of bacteria of 143 cases were detected during the first trimester of pregnancy,342 strains of bacteria of 329 women were detected during the second trimester of pregnancy,and 512 strains of bacteria of 464 women were detected during the third trimester of pregnancy.The main pathogenic bacteria were Gardnerella,Escherichia coli,Pseudomonas aeruginosa and Klebsiella pneumoniae.There were 86 women with adverse pregnancy,with an incidence of 9.2%,including 76 cases with premature delivery and 10 cases with premature rupture of membranes.163 strains and 30 strains of the pathogenic bacteria were detected in 86 women with adverse pregnancy.Gardnerella,Escherichia coli and Klebsiella pneumoniae were the main pathogenic bacteria of the women with premature delivery,and Gardnerella,Escherichia coli and Pseudomonas aeruginosa were the main pathogenic bacteria of the women with premature rupture of membranes.The densities of Gardnerella vaginalis,Escherichia coli,Pseudomonas aeruginosa and Klebsiella pneumoniae of the women with adverse pregnancy outcomes were mainly grade Ⅲ and grade Ⅳ,the density of Lactobacillus of the women with adverse pregnancy outcomes was mainly grade O and grade Ⅰ,and which of all were statistically different from those of the women with normal pregnancy outcomes.The richness of the vaginal flora during the first,the second and the

关 键 词：妊娠期 细菌性阴道病 菌群特征 早产 胎膜早破 不良妊娠结局 相关性 

分 类 号：R714.2[医药卫生—妇产科学]