健康体检妇女阴道菌群状况及相关知识问卷调查分析

Investigation of the situation of vaginal microflora in healthy women population

目的了解健康体检妇女阴道菌群状况及其对下生殖道感染相关知识的认知度和个人卫生习惯、就医行为等特点。方法对1660例健康体检妇女的阴道分泌物行常规镜检、pH值测定及细菌培养，并随机选择其中的875例进行问卷调查，内容涉及生殖道感染相关知识及个人卫生习惯和就医行为。结果（1）阴道菌群状况：1660例健康体健妇女阴道pH值平均为4．16±0．21，阴道分泌物常规镜检假丝酵母菌的阳性率为3．86％（64／1660）；细菌培养结果显示，需氧菌阳性率为7．71％（128／1660），其中自假丝酵母菌、光滑假丝酵母菌和克柔假丝酵母菌阳性率分别为78．9％（101／128）、7．8％（10／128）、7．0％（9／128）。阴道菌群中以甲型溶血性链球菌为主，检出率达63．80％（1059／1660），其次是表皮葡萄球菌和粪肠球菌（D）群，检出率各达14．28％（237／1660）和11．44％（190／1660）。（2）问卷调查结果：875份调查问卷中，收回合格调查问卷860份，其中88．4％（760／860）的妇女对生殖道感染有积极的认知，在感到不适时即自觉就诊；92．1％（792／860）的妇女有良好的卫生习惯；50．0％（430／860）的妇女渴望通过医院门诊咨询途径获得生殖健康知识。结论外阴阴道假丝酵母菌感染居各类阴道炎之首，其中仍以白假丝酵母菌感染为主，其次是光滑假丝酵母菌和克柔假丝酵母菌。健康体检女性阴道菌群分布以甲型溶血性链球菌和表皮葡萄球菌等正常菌群为主，被调查妇女的卫生保健意识较强，医院门诊应加强对生殖道感染相关知识的宣传。

Objective To assess the distribution of vaginal microflora in healthy women and investigate their eognition of lower reproductive tract infection-related knowledge as well as personal hygiene habits and character of behavior in seeking medical treatment. Methods Total of 1660 healthy women who had physieal check-ups at the Medical Center of Renji Hospital were selected and received gynecologic examination, as well as routine examination, pH examination and bacterial culture of the vaginal discharge. In addition, 860 of them were randomly selected for questionnaire survey, in which reproductive tract infection -related knowledge and personal hygiene habits as well as behavior in seeking medical treatment were involved. Results Among the 1660 censused women, vaginal average pH was 4. 16 ± 0.21. The positive rate of Candida in vaginal discharge routine examination was 3.86% （64/1660）, which was lower than that in aerobes culture 7.71% （128/1660）. Candida albicans was the most populous species 78.9% （ 101/128 ） ,followed by 7.8% （ 10/128 ） and 7.0% （9/128） for the Candida glabrata and Candida krusei respectively. The most populous species of vaginal microflora were hemolytic streptococcus A （63, 80%, 1059/1660）, Staphylococcus epidermidis （ 14. 28%, 237/1660）, and Enterococcus faecalis （D） group （11.44%, 190/1660）. The questionnaire survey showed that 88.4% （760/860） of 860 women took active treatment when feeling unwell, 92.1% （792/860） of them had good hygiene practices, and only 21.2% （182/860） had the habit of vaginal douching. In addition, 50.0% （430/860） of them had the desire to obtain reproductive health knowledge through out-patient consultation. Conclusions Vulvovaginal Candida disease ranks the first in all types of vaginitis, among which, Candida albicans is the most populous species followed by the Candida glabrata and Candida krusei. Hemolytic streptococcus A and Staphylococcus epidermidis are the most common species of vaginal microflora in healthy women. The censused women have high awareness of reproductive health care and pay much attention to common gynecologic diseases such as lower reproductive tract infection. Nevertheless, we should strengthen the public education of reproductive health-related knowledge.