需氧菌性阴道炎及其混合感染的临床特征分析

Analysis of Clinical Features About Aerobic Vaginitis and Mixed Infection

目的：探讨需氧菌性阴道炎及其混合感染的临床特征及发病规律。方法：收集638例外阴不适、阴道分泌物异常等阴道炎症状患者,分析不同类型阴道炎的分布及临床特征情况。结果：638例患者中,AV14.6%,BV61.6%,VVC36.5%,TV 8.0%。AV患者中混合感染54例,其中AV合并BV44.4%,AV合并VVC29.6%,AV合并TV 25.9%。单纯AV患者主要临床症状为阴道分泌物性状如颜色、质地等的改变;单纯BV以阴道分泌物异味为主,单纯VVC以外阴瘙痒为主。AV合并BV感染主要临床症状为阴道分泌物异味,AV合并VVC或TV主要为外阴瘙痒。单纯AV、BV及AV混合感染p H值〉4.5的比例无明显差异,单纯VVC的p H值〉4.5者比例最低;单纯AV胺试验阳性较低,BV及AV合并BV最高;单纯AV患者清洁度Ⅲ~Ⅳ度比例最高,单纯BV最低,差异有统计学意义（P〈0.05）。单纯AV患者细菌培养可见粪肠球菌、链球菌、葡萄球菌。结论：AV易发生混合感染,以阴道分泌物多为黄绿色稀薄脓性,且伴性交痛或外阴阴道不适感、清洁度较高、胺试验阴性等主要表现。细菌主要为需氧菌,如粪肠球菌、链球菌等。AV混合感染缺乏特异性临床特征,因此应行多种阴道炎的检测以排除合并感染,提高AV的诊断准确性。

Objective： To investigate the clinical features and pathogenesis of aerobic vaginitis and mixed infection.Methods： The symptoms of 638 patients with vaginitis,such as vulvar discomfort,abnormal vaginal discharge,and the clinical distribution and characteristics of different vaginitis were analysed. Results： In 638 patients,AV ratio was 14. 6%; BV was61. 6%;VVC was 36. 5%; TV was 8%. In AV patients,there were 54 cases with mixed infection,in which 44. 4% was AV merged with BV; 29. 6% was AV merged with VVC; 25. 9% was AV merged with TV. Most clinical symptoms of simple AV patients were vaginal secretion such as color,texture change; more clinical symptoms of BV was only vaginal secretions unusual smell,more clinical symptoms of simple VVC was vulva pruritus. Main clinical symptoms of AV combined with BV infection were vaginal odor. Main clinical symptoms of AV combined with VVC or TV were genital itching. The ration of p H 4. 5 was in only AV; BV combined with AV was no significant differences. The proportion of p H〉4. 5 in VVC patients was the lowest,the positive amine test was lower in AV patients,but the highest was in AV combined with BV patients. The proportion of cleanliness degree Ⅲ- Ⅳin patients with AV was the highest. Patients with simple BV was the lowest,the differences was statistically significant（ P〈0. 05）. The germiculture of patients with AV had visible enterococcus faecalis,streptococcus,staphylococcus aureus.Conclusion： AV is easy to occur in mixed infection; patient＇s vaginal secretions are yellow- green color and with sexual pain or vaginal discomfort,and high cleanliness,amine test negative. Bacteria is mainly aerobic bacteria,such as enterococcus faecalis,streptococcus. AV mixed infection is lack of clinical feature. Therefore detection of various vaginitis should be ruled out mixed infection to improve diagnostic accuracy of AV.