萎缩性阴道炎影响因素分析

Analysis of influencing factors for atrophic vaginitis

目的探讨萎缩性阴道炎的影响因素。方法选取125例萎缩性阴道炎患者(病例组)和130例健康绝经女性(对照组),对阴道分泌物进行细菌培养,检测血清抗苗勒氏管激素(AMH)、促卵泡激素(FSH)、黄体生成素(LH)水平。分析萎缩性阴道炎的影响因素;采用ROC曲线分析血清FSH、AMH水平和FSH/LH比值对萎缩性阴道炎的预测价值。结果与对照组相比,病例组嗜血杆菌、类杆菌属、大肠杆菌检出率高,乳酸杆菌检出率低(P<0.01)。病例组血清FSH水平和FSH/LH比值高于对照组,AMH水平低于对照组(P<0.01)。ROC曲线分析显示,取FSH临界值45.50 IU/L时,FSH诊断萎缩性阴道炎的灵敏度和特异度分别为95.3%和43.8%;取AMH临界值0.48 ng/mL时,AMH诊断萎缩性阴道炎的灵敏度和特异度分别为89.4%和63.5%;取FSH/LH比值临界值3.42时,FSH/LH比值诊断萎缩性阴道炎的灵敏度和特异度分别为83.1%和74.1%。Logistic回归分析显示,FSH>45.50 IU/L、AMH<0.48 mg/mL及FSH/LH比值>3.42是萎缩性阴道炎的危险因素(P<0.05)。结论萎缩性阴道炎患者阴道微生态处于失衡状态,乳酸杆菌减少,嗜血杆菌、类杆菌属和大肠杆菌增多。AMH、FSH和FSH/LH比值对萎缩性阴道炎有较高的预测价值,FSH>45.50 IU/L、AMH<0.48 mg/mL和FSH/LH比值>3.42是萎缩性阴道炎的危险因素。

Objective To investigate the influencing factors for atrophic vaginitis.MethodsThe bacterial culture of vaginal fluid was conducted in 125 cases with atrophic vaginitis(group A)and 130 healthy menopausal women(group B).Serum levels of anti-Müllerian tube hormone(AMH),follicle stimulating hormone(FSH)and luteinizing hormone(LH)were detected in two groups.The influencing factors for atrophic vaginitis were analyzed by binary logistic regression.ROC curve analysis was used to analyze the predictive value of FSH,AMH and FSH/LH ratio for atrophic vaginitis.Results The detection rate of Haemophilus,Bacteroides and Escherichia coli was higher and that of Lactobacillus was lower in group A than those in group B(P<0.01).The FSH level and FSH/LH ratio were higher and that of AMH was lower in group A than those in group B(P<0.01).Taking 45.50 IU/L as the cut-off value of FSH,the sensitivity and specificity of FSH diagnosing the atrophic vaginitis were 95.3%and 43.8%,respectively.Taking 0.48 ng/mL as the cut-off value of AMH,the sensitivity and specificity of AMH diagnosing the atrophic vaginitis were 89.4%and 63.5%,respectively.Taking 3.42 as the cut-off value of FSH/LH ratio,the sensitivity and specificity of FSH/LH ratio diagnosing the atrophic vaginitis were 83.1%and 74.1%,respectively.Binary logistic regression analysis showed that FSH>45.50 IU/L,AMH<0.48 mg/mL and FSH/LH ratio>3.42 were the risk factors for atrophic vaginitis(P<0.05).ConclusionEndovaginal microecologics of atrophic vaginitis is out of balance,of which Lactobacillus is decreased,Haemophilus,Bacteroides and Escherichia coli are increased.AMH,FSH and FSH/LH ratio have high predictive value for atrophic vaginitis.FSH>45.50 IU/L,AMH<0.48 mg/mL and FSH/LH ratio>3.42 are the risk factors for atrophic vaginitis.