女性外阴瘙痒与白念珠菌超敏反应的关系

Vulvar pruritus and Candida albicans hypersensitivity

目的外阴阴道念珠菌病(vulvovaginal candidiasis,VVC)为外阴瘙痒常见病因。文中旨在探讨外阴瘙痒与白念珠菌超敏反应之间的关系。方法制备白念珠菌斑贴变应原。收集2011-03-06至2011-05-10南京军区南京总医院门诊87例女性患者资料,分为3组,其中33例VVC患者为VVC组,26例有VVC病史的患者为VVC病史组,28例皮炎湿疹患者为对照组。对VVC组和VVC病史组患者分别进行白念珠菌斑贴试验及点刺试验(skin prick test,SPT),分析研究白念珠菌超敏反应与外阴瘙痒之间的关系。结果 VVC组和VVC病史组白念珠菌SPT均为阴性。在白念珠菌斑贴试验中,VVC组斑贴阳性率(54.5%)和VVC病史组(50.0%)较对照组(17.9%)显著升高(P=0.003,P=0.012),但VVC组和VVC病史组之间差异无统计学意义(P=0.728)。VVC组和VVC病史组共有10例患者对0.4%和1%低浓度白念珠菌斑贴试剂较高浓度的试剂反应更加明显,且不同程度外阴瘙痒患者之间的斑贴阳性率差异无统计学意义(P=0.208)。结论外阴瘙痒患者的白念珠菌斑贴阳性率较高,提示白念珠菌超敏反应在外阴瘙痒中发挥重要作用。

Objective Persistent vulvar pruritus is a frequent problem, and vulvovaginal candidiasis （VVC） is a common cause. The aim of this study is to investigate the relationship between vulvar pruritus and candidal hypersensitivity. Methods Can-dida albieans allergen was prepared for patch test. Thirty-three patients with VVC and 26 with a VVC history underwent patch test and skin prick test for Candida albicans allergen. Another 28 females with dermatitis and atopic dermatitis but no history of VVC were in-cluded as controls. The relationship of vulvar itching with candidal hypersensitivity was analyzed. Results The patients with VVC and those with a VVC history were all negative in Candida albicans skin prick tests, while patch tests showed higher positive rates of Candida albicans in both the two groups than in the controls （P = 0. 003, P = 0. 012） , but with no significant differences between the former two groups （ P = 0.728 ）. Ten patients in the VVC and VVC history groups exhibited more obvious reactions in patch tests to lower concentrations of Candida albicans （0.4% and 1% ）. No statistically significant differences were found in the positive rate of patch test among the patients with different degrees of vulvar pruritus in the VVC and VVC history groups （ P = 0. 208 ）. Conclusion Patients with vulvar pruritus have a high positive rate of Candida albieans, which suggests that eandidal hypersensitivity plays an impor-tant role in vulvar pruritus.