阴道微生态的临床研究及意义

The Clinical Study and Significance of Micro-ecological Mechanism in Vagina

目的:研究人群的阴道微生态状况,为阴道炎症的防治提供新思路。方法:采用整群二级抽样方式,随机抽取313例符合条件的育龄妇女进行调查及阴道微生态检测(其中阴道炎症74例),采用成组病例对照法进行分析。结果:阴道微生态失调者阴道pH值4.4,明显高于阴道微生态正常者4.0(t=6.3581,P<0.01),但并未超出阴道正常酸性环境范围;各类阴道炎症患者的阴道pH均值增高更为明显(P均<0.01),且均超出了阴道正常的酸性环境范围。微生态失调者阴道乳杆菌和H2O2(+)检出率均明显低于微生态正常者(P均<0.01),而阴道炎症者此两项指标降低更为明显(P均<0.01),且阴道炎症患者乳杆菌检出率明显低于无阴道炎症妇女(27.0%vs74.9%,P<0.01)。阴道乳杆菌检出率降低幅度越大,患常见阴道炎症的相对危险度就会越高(P均<0.01)。结论:阴道pH值升高可作为阴道微生态异常状况的预警信号;阴道乳杆菌检出率可作为阴道健康状况的监测指标或阴道炎症治疗后的康复指标。

Objective：To investigate vaginal micro-ecological status in community population, The objec- tive was to provide a new way for prevent and cure lower reproductive tract infections. Methods ：313 women of childbearing age （including 74 vaginitis cases） were selected randomly by cluster sub-sampling. The group case control method was used for data analysis. Results： The pH mean value was 4.4 in disorder group of vaginal micro-ecology, which was significant higher than 4. 0 in normal group of vaainal micro-ecolo-gy （ t=6. 3581, P〈0. 01 ）. But it did not exceed the normal extent of the vaginal acidity. Moreover pH mean value among the vaginitis groups had more significant increase （all P 〈0.01 ）, which had exceeded the nor- mal extent of the vaginal acidity, as compared to the normal group. The detection rates of lactobacillus and H202 （ ＋ ） in vagina among disorder group of vaginal micro-ecology were significantly lower than normal group （all P 〈0. 01 ）. And the detection rates of these two indices among vaginitis group had more signifi-cant decrease compared with the normal group （all P 〈 0. 01 ）. The detection rate of vaginal lactobacillus in patients with vaginatis was also significantly lower than women without vaginitis （27.0% vs 74. 9%, P 〈 0. 01 ）. The lower detection rate of vaginal lactobacillus, the higher risk of common vaginitis （all P〈0. 01 ）. Conclusions：The increasing of vaginal pH value could be considered as an early warning signal of abnormal vaginal micro-ecology. The detection rate of lactobacillus in vagina could be used as an index for monitoring vaginal health state and rehabilitation level after RTIs therapy.