BV快速检测法与常规标准法临床应用比较

Comparison of results of diagnosis of bacterial vaginosishod with several methods.

目的通过细菌性阴道病(Bacterial vaginosis,BV)的体外快速检测与常规标准法线索细胞查找法的符合率比较,探讨其联合使用的实用性,并通过Nugent积分法及清洁度的检查,分析BV患者阴道中微生态系统的改变情况。方法选取疑为阴道炎患者449例,对其阴道分泌物用生理盐水稀释后,涂片检查清洁度,待干后革兰染色,镜下查找线索细胞及Nugent积分法检测;用剩余稀释标本同时作改良胺试验及唾液酸酶法快速检测,结果作出比较分析。结果线索细胞法、Nugent积分法、改良胺试验、唾液酸酶法、改良胺试验+唾液酸酶法的阳性率分别为10.9%、11.8%、12.2%、12.7%、10.2%,与线索细胞检出阳性率无显著差异性;镜下观察中,与阴性标本作比较,BV阳性标本的革兰阳性杆菌数大量减少或无,而其它厌氧菌相对增多;BV阳性标本的白细胞数趋于正常值范围。以查出线索细胞作标准,改良胺试验、唾液酸酶法、改良胺试验+唾液酸酶法的符合率分别为96.0%、96.2%、97.1%,显示联合检测可提高准确率。结论BV患者的阴道微生态发生改变,由阴道加德纳菌及其它厌氧菌破坏了正常状态下的乳酸杆菌所维持的微生态平衡;快速检测法唾液酸酶法及改良胺试验都具有快速,简便,可批量检测等优点,均可供临床应用。

Objective To compare the coincidence rate of several methods in diagnosis of bacterial vaginosis（BV）and discuss its practical value. Methods The vaginal secretion samples collected from 449 suspected patients were diluted with NS,and detected with microscope by Ameliorated-whiff, BV-Blue ,clue-ceU method and Nugent method after Gram staining. Results The positive rates of clue-cell method,Nugent method,Ameliorated-whiff, BV-Blue,Ameliorated-whiff in combination with BV-Blue were 10.9%, 11.8%, 12.2% ,12.7% and 10.2% ,respectively. Compared to clues cells,the positive rate of detection had no significant difference; Under the microscope,compared to the negative samples, the quatity of Gram-positive bacilli was greatly reduced or few, while the number of other anaerobic bacteria was increased in samples positive kfor BV. The quantity of leukocyte in samples positive for BV was in the normal range. The coincidence rates of Ameliorated -whiff, BV -Blue, Ameliorated -whiff incombination with BV -blue,with clue -cell as standard,were 96.0%, 96.2% ,97.1% ,respectively indicating that the accuracy could be enhanced by joint detection. Conclusion The vaginal microenvironment maintained by Lactobacillus in BV patients has been changed due to Gardnerella vaginalis and other anaerobic bacteria infection; the methods of BV-Blue and Ameliorated-whiff are rapid,simple ,and They allowed batch processing and are suitable for clinial application.