20例阴道内放置NuvaRing避孕环后微环境的改变

Changes of vaginal microenvironment in 20 women after Nuva Ring contraceptive ring placement

目的探讨20例阴道内放置Nuva Ring避孕环后微环境的变化。方法对20例使用过避孕环的妇女(自身对照),利用阴道炎五联检法和显微镜观察法处理带环前后不同周期的阴道分泌物,并用放射免疫法检测阴道灌洗液中炎性因子IL-2和IL-8在带环前后不同浓度的变化。结果与放置阴道避孕环前比较,炎性因子IL-2和IL-8带环1个周期后浓度呈上升趋势(P<0.05);带环3、6个周期后IL-2、IL-8浓度逐渐下降并趋于正常(P>0.05)。经阴道五联检及显微镜下检测,阴道分泌物的p H值、白细胞、乳酸杆菌、细菌性阴道病(BV)、霉菌性阴道炎(VVC)、滴虫性阴道炎(TV)各项与带环前无明显变化。结论阴道放置避孕环后对炎性因子IL-2、IL-8初期有所影响,但随着阴道对环的适应及机体自身的调节会使IL-2、IL-8逐渐趋于正常;同时阴道环对阴道分泌物中的乳酸环境无明显影响,不会导致其他杂菌的生长。

Objective To study the changes of vaginal microenvironment after Nuva Ring contraceptive ring placement.Methods For 20 women who received vaginal contraceptive ring placement,vaginal discharge of different cycles were examined with five joint inspections of vaginitis and microscopy. Concentrations of IL-2 and IL-8 in vaginal lavage of all subjects were determined with radioimmunoassay（ RIA）. Results After the ring was placed for a cycle,the concentrations of IL-2 and IL-8 were risen（ P〈0. 05）. How ever,after the ring was placed for 3 to 6 cycles,the concentrations of IL-2 and IL-8 dropped and returned normal（ P〈0. 05）. Five joint inspections of vaginitis and microscopy show ed that p H value,quantification of leukocytes,lactobacilli,bacterial vaginosis（ BV）,vulvovaginal candidiasis（ VVC）,and trichomonal vaginitis（ TV） of vaginal discharge had no significant difference compared with the indexes before the ring was placed. Conclusion Vaginal contraceptive ring increases the concentrations of IL-2 and IL-8 initially,which will return normal after vagina adaptes to the ring. Vaginal ring has no obvious effects on vaginal acid circumstances and couldnt lead to the growth of other bacteria.