惠州地区育龄妇女阴道微生态失衡因素调查
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摘要
目的探讨阴道炎患者的阴道微生态状况,为进一步施行干预措施提供依据。方法选择2017年3月至2018年6月我院5 559名临床诊断为阴道炎的妇女及3001名健康体检妇女为研究对象,采用病例对照研究,采集研究对象下阴道1/3处的白带样本进行阴道微生态检测,判定研究对象的阴道微生态状况。结果阴道炎患者的阴道微生态失衡状况较健康体检组妇女更严重。本地妇女发生阴道炎的因素为阴道清洁度Ⅲ～Ⅳ度(OR=1.64,P<0.001)、阴道出现炎症白细胞(OR=1.14,P=0.003)、阴道检出酵母菌菌丝/孢子(OR=2.02,P<0.001)及阴道菌群乳杆菌比例较低(OR=2.13,P<0.001)。结论本地区育龄妇女阴道微生态存在失衡状况,下一步需提出合理干预措施,降低阴道微生态失衡的发生。
Objective To investigate the status of vaginal microecology in women of childbearing age,and provide experimental evidence for further intervention.Methods A total of 5,559 women with clinical diagnosis of vaginitis and 3,001 healthy women were enrolled.A case-control study was conducted.Specimens of vaginal secretions were collected for vaginal microecology detection,and the vaginal microecology of the study subjects were evaluated.Results The imbalance of vaginal microecology in women with vaginitis was severer than in healthy women.The factors associated with the imbalance of vaginal microecology of women with vaginitis were vaginal cleanliness III-IV(OR=1.64,P<0.001),positive for white blood cells(OR=1.14,P=0.003),positive for yeast hyphae/spores(OR=2.02,P<0.001)and lower proportion of vaginal Lactobacilli(OR=2.13,P<0.001).Conclusion The imbalance of vaginal microecology exists in the local women with vaginitis.A reasonable intervention measure should be proposed to reduce the risk of vaginal dysbiosis in the population.
Objective To investigate the status of vaginal microecology in women of childbearing age,and provide experimental evidence for further intervention.Methods A total of 5,559 women with clinical diagnosis of vaginitis and 3,001 healthy women were enrolled.A case-control study was conducted.Specimens of vaginal secretions were collected for vaginal microecology detection,and the vaginal microecology of the study subjects were evaluated.Results The imbalance of vaginal microecology in women with vaginitis was severer than in healthy women.The factors associated with the imbalance of vaginal microecology of women with vaginitis were vaginal cleanliness III-IV(OR=1.64,P<0.001),positive for white blood cells(OR=1.14,P=0.003),positive for yeast hyphae/spores(OR=2.02,P<0.001)and lower proportion of vaginal Lactobacilli(OR=2.13,P<0.001).Conclusion The imbalance of vaginal microecology exists in the local women with vaginitis.A reasonable intervention measure should be proposed to reduce the risk of vaginal dysbiosis in the population.
引文
[1]马樱洁.女性生殖道感染的临床检验及结果分析[J].中国校医,2018,32(4):287.
[2]JIN Liefeng,MA Haiqin.Clinical analysis on 19519cases of female genital tract infections in Haining area[J].Chin J Microecol,2018,30(4):468-470.(in Chinese)金列峰,马海琴.海宁地区19519例女性生殖道感染情况分析及临床意义探讨[J].中国微生态学杂志,2018,30(4):468-470.
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[4]PENG Liqun,LIU Zhimin,LIANG Ruifang.Vaginitis of common disease types and the distribution of common pathogens[J].Contemp Med,2017,23(23):52-54.(in Chinese)彭利群,刘志敏,梁瑞芳.阴道炎的常见发病类型及其常见病原体的分布状况[J].当代医学,2017,23(23):52-54.
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[6]DING Yanling,FU Jinjian,WU Yubi,et al.Epidemiological observation on vaginal microecology in women in late pregnancy[J].Chin J Microecol,2018,30(4):461-464.(in Chinese)丁燕玲,傅锦坚,吴宇碧,等.孕晚期妇女阴道微生态流行病学调查分析[J].中国微生态学杂志,2018,30(4):461-464.
[7]Farr A,Kiss H,Hagmann M,et al.Role of Lactobacillus Species in the intermediate vaginal flora in early pregnancy:Aretrospective cohort study[J].PLoS One,2015,10(12):e0144181.
[8]Tansarli GS,Skalidis T,Legakis NJ,et al.Abnormal vaginal flora in symptomatic non-pregnant and pregnant women in a Greek hospital:A prospective study[J].Eur J Clin Microbiol Infect Dis,2017,36(2):227-232.
[9]LIAO Qinping,CHEN Rui.Application situation and the prospect of big data in obstetrical and gynecological microbiology[J].Chin JPract Gynecol&Obstet,2018,34(1):52-55.(in Chinese)廖秦平,陈锐.大数据在妇产科微生态领域中的应用现状及展望[J].中国实用妇科与产科杂志,2018,34(1):52-55.
[10]JIANG Jianfeng,WU Fenying,Ni Huijuan,et al.Effects of different regimens on pregnancy outcome of pregnant women with bacterial vaginal infection[J].Chin J Nosocomiol,2018,28(14):2162-2164.(in Chinese)蒋建峰,吴芬英,倪惠娟,等.不同治疗方案对细菌性阴道感染妇女妊娠结局的影响研究[J].中华医院感染学杂志,2018,28(14):2162-2164.
[11]CHEN Fangjuan,WANG Xianyu,CAI Jianfen,et al.Clinical characteristics of bacterial vaginosis patients complicated with other gynecological infectious diseases and therapeutic effects[J].Chin J Nosocomiol,2018,28(14):2159-2161.(in Chinese)陈芳娟,王仙玉,蔡建芬,等.细菌性阴道病合并其他妇科感染性疾病的临床特点和治疗效果分析[J].中华医院感染学杂志,2018,28(14):2159-2161.
[12]何素妮,傅文君.乳酸菌阴道胶囊联合口服维生素D治疗妊娠期细菌性阴道病的疗效[J].中国妇幼保健,2018,33(13):2968-2970.
[13]REN Chuanwei,ZHAO Shimei.The clinical features of bacterial vaginosis and other gynecological infections[J].J Pathog Biol,2018,13(4):421-423.(in Chinese)任传伟,赵时梅.细菌性阴道炎合并妇科感染性疾病的临床特点[J].中国病原生物学杂志,2018,13(4):421-423.
[14]QIU Xiaofei,LIN min,YAO Zhaonan,et al.Analysis of the detection results of vaginal secretions and cervical chlamydia and mycoplasma[J].Chin J Nosocomiol,2017,27(6):1370-1373.(in Chinese)邱笑飞,林敏,姚招男,等.女性患者阴道分泌物及宫颈衣原体与支原体检测结果分析[J].中华医院感染学杂志,2017,27(06):1370-1373.
[15]LI Yejing,WU Xiaoli,GAO Han.Analysis of the vaginal secretions test results of 284vaginitis patients and its risk factors[J].Chin J Human Sexual,2017,26(2):45-48.(in Chinese)李叶静,吴晓莉,高晗.284例阴道炎患者阴道分泌物检验结果分析及危险因素研究[J].中国性科学,2017,26(2):45-48.
[16]WANG Chen,XUE Fengxia.Role of evaluation of vaginal microecology in the diagnosis of aerobic vaginitis[J].Chin J Pract Gynecol&Obstet,2017,33(8):779-782.(in Chinese)王辰,薛凤霞.阴道微生态评价对需氧菌性阴道炎的诊断作用[J].中国实用妇科与产科杂志,2017,33(8):779-782.
[17]ZHANG Dai,LIN Huaixian,LIAO Qinping,et al.The study on the therapeutic effects fo r patients with aerobian vaginitis[J].Chin J Clin Obstet&Gynecol,2017,18(1):33-35.(in Chinese)张岱,林怀宪,廖秦平,等.治疗需氧菌阴道炎的随机对照研究[J].中国妇产科临床杂志,2017,18(1):33-35.
[18]Wang ZL,Fu LY,Xiong ZA,et al.Diagnosis and microecological characteristics of aerobic vaginitis in outpatients based on preformed enzymes[J].Taiwan J Obstet Gynecol,2016,55(1):40-44.
[2]JIN Liefeng,MA Haiqin.Clinical analysis on 19519cases of female genital tract infections in Haining area[J].Chin J Microecol,2018,30(4):468-470.(in Chinese)金列峰,马海琴.海宁地区19519例女性生殖道感染情况分析及临床意义探讨[J].中国微生态学杂志,2018,30(4):468-470.
[3]CHEN Li,ZHU Ling,YU Huilan,et al.Distribution of pathogens causing genital tract infections and influencing factors[J].Chin J Nosocomiol,2018,28(6):915-917.(in Chinese)陈俐,朱玲,于辉兰,等.生殖道感染病原菌分布及影响因素分析[J].中华医院感染学杂志,2018,28(6):915-917.
[4]PENG Liqun,LIU Zhimin,LIANG Ruifang.Vaginitis of common disease types and the distribution of common pathogens[J].Contemp Med,2017,23(23):52-54.(in Chinese)彭利群,刘志敏,梁瑞芳.阴道炎的常见发病类型及其常见病原体的分布状况[J].当代医学,2017,23(23):52-54.
[5]肖冰冰,刘朝晖.阴道微生态评价在阴道炎中的应用[J].中国妇产科临床杂志,2016,17(6):483-485.
[6]DING Yanling,FU Jinjian,WU Yubi,et al.Epidemiological observation on vaginal microecology in women in late pregnancy[J].Chin J Microecol,2018,30(4):461-464.(in Chinese)丁燕玲,傅锦坚,吴宇碧,等.孕晚期妇女阴道微生态流行病学调查分析[J].中国微生态学杂志,2018,30(4):461-464.
[7]Farr A,Kiss H,Hagmann M,et al.Role of Lactobacillus Species in the intermediate vaginal flora in early pregnancy:Aretrospective cohort study[J].PLoS One,2015,10(12):e0144181.
[8]Tansarli GS,Skalidis T,Legakis NJ,et al.Abnormal vaginal flora in symptomatic non-pregnant and pregnant women in a Greek hospital:A prospective study[J].Eur J Clin Microbiol Infect Dis,2017,36(2):227-232.
[9]LIAO Qinping,CHEN Rui.Application situation and the prospect of big data in obstetrical and gynecological microbiology[J].Chin JPract Gynecol&Obstet,2018,34(1):52-55.(in Chinese)廖秦平,陈锐.大数据在妇产科微生态领域中的应用现状及展望[J].中国实用妇科与产科杂志,2018,34(1):52-55.
[10]JIANG Jianfeng,WU Fenying,Ni Huijuan,et al.Effects of different regimens on pregnancy outcome of pregnant women with bacterial vaginal infection[J].Chin J Nosocomiol,2018,28(14):2162-2164.(in Chinese)蒋建峰,吴芬英,倪惠娟,等.不同治疗方案对细菌性阴道感染妇女妊娠结局的影响研究[J].中华医院感染学杂志,2018,28(14):2162-2164.
[11]CHEN Fangjuan,WANG Xianyu,CAI Jianfen,et al.Clinical characteristics of bacterial vaginosis patients complicated with other gynecological infectious diseases and therapeutic effects[J].Chin J Nosocomiol,2018,28(14):2159-2161.(in Chinese)陈芳娟,王仙玉,蔡建芬,等.细菌性阴道病合并其他妇科感染性疾病的临床特点和治疗效果分析[J].中华医院感染学杂志,2018,28(14):2159-2161.
[12]何素妮,傅文君.乳酸菌阴道胶囊联合口服维生素D治疗妊娠期细菌性阴道病的疗效[J].中国妇幼保健,2018,33(13):2968-2970.
[13]REN Chuanwei,ZHAO Shimei.The clinical features of bacterial vaginosis and other gynecological infections[J].J Pathog Biol,2018,13(4):421-423.(in Chinese)任传伟,赵时梅.细菌性阴道炎合并妇科感染性疾病的临床特点[J].中国病原生物学杂志,2018,13(4):421-423.
[14]QIU Xiaofei,LIN min,YAO Zhaonan,et al.Analysis of the detection results of vaginal secretions and cervical chlamydia and mycoplasma[J].Chin J Nosocomiol,2017,27(6):1370-1373.(in Chinese)邱笑飞,林敏,姚招男,等.女性患者阴道分泌物及宫颈衣原体与支原体检测结果分析[J].中华医院感染学杂志,2017,27(06):1370-1373.
[15]LI Yejing,WU Xiaoli,GAO Han.Analysis of the vaginal secretions test results of 284vaginitis patients and its risk factors[J].Chin J Human Sexual,2017,26(2):45-48.(in Chinese)李叶静,吴晓莉,高晗.284例阴道炎患者阴道分泌物检验结果分析及危险因素研究[J].中国性科学,2017,26(2):45-48.
[16]WANG Chen,XUE Fengxia.Role of evaluation of vaginal microecology in the diagnosis of aerobic vaginitis[J].Chin J Pract Gynecol&Obstet,2017,33(8):779-782.(in Chinese)王辰,薛凤霞.阴道微生态评价对需氧菌性阴道炎的诊断作用[J].中国实用妇科与产科杂志,2017,33(8):779-782.
[17]ZHANG Dai,LIN Huaixian,LIAO Qinping,et al.The study on the therapeutic effects fo r patients with aerobian vaginitis[J].Chin J Clin Obstet&Gynecol,2017,18(1):33-35.(in Chinese)张岱,林怀宪,廖秦平,等.治疗需氧菌阴道炎的随机对照研究[J].中国妇产科临床杂志,2017,18(1):33-35.
[18]Wang ZL,Fu LY,Xiong ZA,et al.Diagnosis and microecological characteristics of aerobic vaginitis in outpatients based on preformed enzymes[J].Taiwan J Obstet Gynecol,2016,55(1):40-44.