激素替代治疗对阴道菌群的影响

INFLUENCE OF HORMONE REPLACEMENT THERAPY ON VAGINAL FLORA

目的 研究更年期综合征妇女激素替代治疗前后阴道菌群的变化。方法 更年期综合征病人进行激素替代治疗者共 2 5例 ,于治疗前及第 3个月 0 .2 ml定量刮匙取阴道穹隆部分泌物 ,进行菌群分析。结果 2 5例中有 18例坚持治疗 3个月 ,7例因症状有缓解或其他原因只用药 1～ 2个月即停止治疗。 18例坚持治疗者中有 10例阴道乳酸杆菌数量明显增加 ,成为阴道菌群中的优势菌。6例乳酸杆菌明显下降或无法检出 ,由其他细菌取代为绝对优势而出现菌群失调。 2例阴道菌群无明显变化。 7例治疗间断者有 3例出现菌群失调。结论 短期激素替代治疗对阴道菌群有较大影响 ,多数情况能使乳酸杆菌数目增加至绝对优势 ,其他细菌的数目下降。但不论是否坚持激素替代治疗 ,均出现了部分病例菌群失调的现象。

To investigate the influence of Hormone Replacement Therapy on vaginal flora. Methods:25 cases selected from the policlinic patients with obvious climacteric syndromes accepted HRT, Premarin were used as estrogen replacement drug. 0.625mg Premarin were taken orally per day, The vaginal secretion were collected by 0.2ml spoon before HRT and the third month of HRT and part of the flora were analyzed. Result:There were 18 cases who took HRT for 3 months in all the 25 cases, In 10 cases of them, the number of lactobacilli rose obviously, while staphylococci, streptococci coliforms and enterococcus had a down trend, There were dysbacteriosis in 6 cases. The lactobacilli decreased obviously or none of it could be determined at all, but some other bacterium occupied an absolutely dominant, and the other 7 cases stopped HRT after 1 or 2 months. 3 of them had dysbacteriosis. Conclusion: short term HRT had a strong influence on vaginal flora. In most cases it can make a rise of lactobacilli, and other several bacteria decreased, But there were dysbacteriosis in cases both took HRT for 3 months and those only for 1 or 2 months.