妊娠与非妊娠妇女下生殖道感染比较

Comparison of lower genital tract infection between pregnant women and non-pregnant women

目的:探讨妊娠与非妊娠妇女下生殖道感染状况。方法:随机选取常规围产期保健妇女180例(早期妊娠60例、中期妊娠60例、晚期妊娠60例)采集阴道分泌物,测定pH值,检测外阴阴道假丝酵母菌病、滴虫性阴道炎、细菌性阴道病,宫颈分泌物,利用DNA杂交导流技术检测人乳头瘤病毒(HPV)及基因分型。选择60例非妊娠期健康妇女进行相同的检查作为对照。结果:阴道pH值在妊娠各期均低于非妊娠期(P<0.01)。妊娠期细菌性阴道病(BV)、外阴阴道假丝酵母菌病(VVC)及HPV感染率分别是19.4%、21.7%、28.9%,非妊娠期三项感染率分别为8.3%、10.0%、15.0%,妊娠期高于非妊娠期妇女(P<0.05)。不同妊娠期别HPV感染率及基因亚型不同,妊娠晚期HPV感染率最高,达46.7%,明显高于早、中妊娠期HPV感染率(P<0.05)。妊娠妇女高危型HPV感染率高于非妊娠妇女,以妊娠晚期明显,且部分伴有多重型感染。结论:妊娠期妇女下生殖道感染发生率高,尤应注意HPV感染,需要重复检测,加强随访。

Objective：To explore the lower genital tract infection status of pregnant women and non-pregnant women.Methods：180 women receiving routine health care during perinatal period were selected,including 60 pregnant women during the first trimester of pregnancy,60 pregnant women during the second trimester of pregnancy and 60 pregnant women during the third trimester of pregnancy,their vaginal secretions were collected,pH value was tested;vulvovaginal candidiasis,trichomonas vaginitis,bacterial vaginosis and cervical secretions were detected,DNA hybridization diversion technology was used to detect human papillomavirus（HPV） and genotyping.60 non-pregnant healthy women were selected as control group.Results：Vaginal pH values during different pregnant periods were significantly lower than that in non-pregnant period（P〈0.01）.The incidences of bacterial vaginosis and vulvovaginal candidiasis,the rate of HPV infection during pregnant period were 19.4%,21.7% and 28.9%,respectively,which were significantly higher than those during non-pregnant period（8.3%,10.0% and 15.0%,respectively）（P〈0.05）.The rate of HPV infection and genotype varied with different pregnant periods,the rate of HPV infection during the third trimester of pregnancy was the highest,up to 46.7%,which was significantly higher than those during the second trimester of pregnancy and the third trimester of pregnancy（P〈0.05）.The rate of high risk HPV infection in pregnant women was higher than that in non-pregnant women,especially the pregnant women during the third trimester of pregnancy,and partial pregnant women combined with multiple infection.Conclusion：The incidence of lower genital tract infection is high in pregnant women,HPV infection should be paid more attention to,repeated detection and enhanced follow-up are necessary.