女性阴道混合感染246例临床分析

Clinical analysis of 246 patients with mixed viginal infection

目的通过微生态的检查,全面评估女性阴道混合感染的微生态状况,为临床诊断治疗提供良好的依据。方法 2009年11月至2010年2月,选择在北京大学第一医院妇科门诊就诊的246例阴道炎患者,观察患者的症状、体征及阴道分泌物pH值,经革兰染色后,在油镜下观察,进行阴道微生态(阴道菌群、乳杆菌分级、需氧菌和炎性反应等)状况评分。结果 246例患者中,单一感染143例(58.1%),混合感染103例(41.9%),细菌性阴道病(BV)+需氧菌阴道炎(A V)者57例(55.3%);外阴阴道假丝酵母菌病(VVC)+A V者25例(24.3%);滴虫阴道炎(TV)+AV者15例(14.6%);VVC+BV+AV者5例(4.9%),AV+单纯疱疹病毒(HSV)感染者1例(1.0%)。混合感染患者发生阴道灼痛(86.4%,89/103)增加,清洁度Ⅲ度(40.8%,42/103)、pH值偏高(pH值>5.0者,20.4%,21/103),乳杆菌减少(乳杆菌Ⅲ者,64.1%,66/103)等,与单一感染患者比较,差异均有统计学意义(P<0.05)。结论阴道混合感染的发生率很高,微生态检查是诊断中非常重要的手段。

Objective To generally evaluate the microecologic situation of women with vaginal mixed infection thus provide evidence for clinical practice.Methods The data of 246 patients with vaginitis treated at outpatient of Peking University First Hospital were studied from November 2009 to February 2010.The pH value of vaginal secretion was detected,the vaginal microenvironment was evaluated under oil immersion lens after Gram staining.Results In the 246 patients,there were 143 cases of single infection（58.1%） and 103 cases of mixed infection（41.9%）.Compared with patients with single infection,the patients with mixed infection had more severe vaginal burning（86.4%,89/103）,higher pH value（pH〉5.0,20.4%） and less Lactobacillus.Conclusions The incidence of vaginal mixed infection is high.The microenvironment examination is an important method for diagnosis.