非药物避孕方式对健康育龄期妇女阴道乳酸杆菌的影响

Effects of non-drug contraception on colonization of lactobacillus in the vagina

目的明确非药物避孕方式对中国健康育龄期妇女阴道乳酸杆菌（LB）的影响。方法纳入164名18～45岁中国健康育龄期妇女进行横断面研究，根据受试者采用非药物避孕方式的不同分为安全套组、宫内节育器组和安全期组。采集受试对象月经第21～22天的阴道拭子，进行阴道分泌物涂片Nugent评分、阴道LB定量培养并检测过氧化氢的产生。应用卡方检验和ANOVA统计方法分析各组间NugentO～3分占比、产过氧化氢LB培养阳性率和菌落计数的差异。结果安全套组93．1％的阴道拭子Nugent评分为0～3分，高于宫内节育器组（75．4％），二者差异有统计学意义（P=0．005）。安全套组产过氧化氢I。B的培养阳性率（82．3％）高于宫内节育器组（68．2％），二者差异有统计学意义（P=0．016）。安全套组产过氧化氢LB菌落计数对数值（x±s）为（7．81±0．14），高于宫内节育器组（6．54±0．14），二者差异有统计学意义（P=0．000）。结论坚持正确使用安全套有利于产过氧化氢LB在阴道内的定植，从而减少细菌性阴道病的发生和HIV感染，对保护健康育龄期妇女生殖健康具有积极意义。

Objective To determine the association between non-hormonal contraception methods and vaginal lactobacilli on women＇s reproductive health. Methods The cross-sectional study included 164 healthy women between 18--45 years of age. The subjects were divided into different groups on the basis of the different non-hormonal contraception methods used by them. At the postmenstrual visit（day 21 or 22 of the menstrual cycle）, vaginal swabs were collected for determination of Nugent score,quantita- tive culture of vaginal tactobacilli. The prevalence, colony counts of the Lactobacillus strains were compared between the different groups by Chi-square and ANOVA statistical analysis methods. Results A Nugent score of 0 3 was more common in the condom group（93, 1%） than in the group that used an interuterine device（IUD） （75.4%）, （P 〈0. 005）. The prevalence of H202-producing Lactobacillus was significantly higher in the condom group（82.3%） than in the IUD group（68.2%）, （P 0. 016）. There was a sig- nificant difference in the log values of H202 producing Iactobacillus colony count（x± s） between condom users（7.81±0.14） and IUD users（6.54±0.14） ,P=0. 000. Conclusion Consistent condom use increases the colonization of H202 producing laetobacillus in the vagina and may protect against both bacterial vaginosis（BV） and human immunodeficiency virus（HIV）.