细菌性阴道病发病机制及诊治进展

Pathogenesis, Diagnosis and Treatment Progress of Bacterial Vaginosis

细菌性阴道病(bacterial vaginosis,BV)是育龄妇女常见阴道感染性疾病,可引起多种并发症。BV是多种致病菌作用的结果,阴道内动弯杆菌、普雷沃菌、类杆菌等厌氧菌及加德纳菌、人型支原体大量繁殖,产过氧化氢的乳杆菌减少。诊断标准包括:常用Amsel标准、实验室采用的Nugent革兰染色法及BV快速诊断酶盒和BVBlue检测法等。BV治疗主要有抗厌氧菌药物甲硝唑、克林霉素。复发性BV指BV在1年内反复发作3次或以上,其高复发率是治疗的难点。

Bacterial vaginosis is the most common vaginal infection in women of reproductive age. It has been linked to serious public health consequences. BV is characterized by a disturbance of the normal vaginal flora, with a loss of H2O2-producing Lactobacillus spp. and an increase in the numbers of anaerobic organisms （Mobiluncus spp., Prevotella spp., and Bacteroides spp.）, Gardneretla vaginalis and Mycoplasma hominis. Conventional diagnostic methods for BV include the Amsel method and the Nugent method. In recent years, rapid diagnostic kits available have FemExam and BVBlue. Treatment of BV primarily includes anti-anaerobe drug metronidazole and clindamycin. Recurrent BV is three or more proved episodes of BV in 12 months, and its high relapse rate give rise to the treatment difficulty.