复发性外阴阴道假丝酵母菌病糖化血红蛋白检测及意义

The significance to test plasma concentration of glycosylated hemoglobin A1c in women with recurrent vulvovaginal candidiasis

目的:探讨常规行糖化血红蛋白A1(HBA1c)检测对治疗复发性外阴阴道假丝酵母菌病(RVVC)的指导价值。方法:将符合RVVC诊断标准的病人65例作为实验组,对照组60例为真菌学阴性的健康体检者及复发性细菌性阴道病(RBV)患者,对所有入选者行空腹及餐后2h血糖、血HBA1c检测并计算体重指数。将HBA1c≥5%的58例RVVC患者随机分为2组,试验1组进行糖代谢调整及抗真菌等综合治疗,试验2组仅抗真菌治疗,治愈后1年内复查HBA1c。结果:实验组HBA1c≥5%58例,占89.2%(58/65),而对照组仅5例,占8.3%(5/60),两组间差异非常显著(P<0.001)。实验组HBA1c、体重指数、空腹血糖均高于对照组,两组间差异非常显著(P<0.001);餐后2h血糖实验组较对照组高,但两组间无显著性差异(P>0.05)。HBA1c≥5%的RVVC患者治愈后1年内的复发率,试验1组2例复发(6.7%),试验2组有14例复发(48.28%),两组间差异显著(P<0.01);1年后试验1组与2组HBA1c≥5%的分别为3例(10.3%)与24例(82.8%),两组间差异非常显著(P<0.001)。结论:复发性外阴阴道假丝酵母菌病的非糖尿病患者,存在糖代谢异常。对复发性外阴阴道假丝酵母菌病的患者进行HBA1c检测对指导临床治疗有一定的价值。

Objective： To access the value of plasma concentration of glycosylated hemoglobin A1c（HBA1c） test routine in treatment of women with recurrent vnlvovaginal eandidiasis （RVVC） . Methods： A case -control study of 65 otherwise healthy women who were diagnosed RVVC according to diagnostic criteria and 60 mycology - negative control subjects, half of whom were healty without infections and half had recurrent bacterial vaginosis （BV）. A1l of whom were undergoing test of fasting glucose, glucose at 2 hours after breakfast and plasma concentration of glycosylated hemoglobin A1c as well as the body mass index were counted. The study - group 58 cases whose HBA1e concentration ≥5% were divided into 2 groups. The study - group 1 were treated with anti - fungus combined with glucose - metabolism - modification therapy. The study - group 2 were only treated with anti - fungus within 1 year after curing, all of these subjects were tested HBA1c again. Results： The proportion of HBA1c ≥5% in study - group was significantly higher than that of control - group （89% vs 8.3%, P 〈 0. 001 ）. Women with RVVC had a significantly greater mean in HBA1c, body mass index and fasting glucose, respectively （ P 〈 0. 001 ）. The level of blood sugar after 2 hours food of the study - group was higher than that of the control, but there were no significant difference between the two groups （ P 〉 0. 05 ）. The incidence of RVVC within 1 year after curing was lower in study - group 1 than that in study - group 2, 2 recurrent cases in study - group 1 and 14 in group 2 （6. 7% vs 48.28%, P 〈 0. 01 ）, the proportion of HBA1c ≥5% was lower in study - group 1 than that in study - group 2 （ 10. 3% vs 82. 8%, P 〈0. 001 ） . Conclusion： The nondiabetie women with RV- VC has glucose metabolism abnormality. To test the plasma concentration of glycosylated hemoglobin A1c in women with RWC is of value and which can guide clinical treatment.