几种细菌性阴道病诊断的临床检验方法对比

A comparison of several diagnostic methods for bacterial vaginosis

目的对Amsel法、BVBlue法、革兰染色Nugent评分法3种细菌性阴道病的临床方法的诊断价值进行对比研究。方法随机抽取2009年7月-2010年9月期间在我院妇科门诊收治并保存有完整临床资料记录，临床表现为外阴不适、白带异常、分泌物有异味的疑似细菌陛阴道病的患者242例。采集受检者阴道分泌物，对其同时进行Amsel法、BVBlue法、革兰染色Nugent评分法诊断，比较3种方法诊断细菌性阴道病的敏感性、特异性、阳性预测值及阴性预测值。结果以Amsel法和革兰染色Nugent法任意1种显阳性即判为BV，计算得3种诊断的方法的灵敏度、特异度、阳性预测值、阴性预测值分别为：Amsel法，72．3％、100％、100％、74．5％；BVBlue法，40．2％、97．5％、93．8％、60．3％；Nugent法，94．6％、100％、100％、88．2％。3种诊断方法在ROC曲线下面积分别为0．863、0．687、0．973，均大于0．5，有一定的诊断价值。结论BV的3种诊断方法均有一定的诊断价值，其中以Nugent的灵敏度和特异度最高，Amsel次之，BVBlue最低。

Objective To explore the diagnostic value of Amsel criteria, BV Blue test, and Nugent score for bacterial vaginosis （ BV ）. Methods 242 patients with suspected BV who had received treatment in our gynecology clinic from July 2009 to September 2010 were included in this study. All the patients had a complete record of clinical data and had symptoms of genital discomfort, abnormal vaginal discharge, discharge with odor. Vaginal discharge was collected and then Amsel criteria, BV Blue test, and Nugent score were used to make diagnosis. The sensitivity, specificity, positive predictive value, and negative predictive value of diagnosing BV were compared among the three methods. Results The diagnosis of BV was made with either Amsel criteria positive or Nugent positive. The sensitivity, specificity, positive predictive value, and negative predictive value were 72.3%, 100%, 100%, and 74.5% for Amsel criteria; 40.2%, 97.5%, 95.8%, and 60.3% for BV Blue test; 94.6%, 100%, 100%, and 88.2% for Nugent score. The area under the ROC curve for the three methods was 0.863, 0.687, and 0.973, all of which were greater than 0.5, having certain diagnostic value. Conclusions All of the three diagnostic methods for bacterial vaginosis have certain diagnostic value. Nugent score has the highest sensitivity and specificity, followed by Amsel criteria, and then BV Blue test.