309例阴道涂片检查与细菌性阴道病关系探讨

Vaginal smear examination and its relationship with bacterial vaginal diseases

目的 以阴道分泌物涂片检查诊断细菌性阴道病及阴道菌群动态观察，探讨其间关系。方法 对309例患者行阴道分泌物涂片直接镜检、革兰氏染色及宫颈粘液镜检，进行线索细胞、细菌定性计数和支原体检查。结果 线索细胞阳性率为55.0%（170／309），支原体为83.6%(204／244）；线索细胞阳性者；乳酸杆菌阴性率为71.8(122/170)，上皮细胞检出率为94.1（160／170）。结论 以线索细胞为诊断和治疗细菌性阴道病的主要依据，阴道常在乳酸杆菌显著减少为辅助指标，白细胞明显不增多，上皮细胞减少，与支原体感染有一定关系。

Objective:By means of vaginal smear examination,to diagnose bacterial vaginal diseases, observe the dynamics of vaginal bacterial flora and ascertain the relationships between them.Methods:For 309 patients,direct microscopy of vaginal discharge smears,Gram staining,microscopy of cervical mucus, bacterial qualitative counts,and examinations of clue cells and mycoplasmas.Results:Positive rate of clue cells accounts for 55.0 percent(170/309),and that of mycoplasmas 83.6 percent(204/244).In patients with positive clue cells,negative rate of lactobacillus accounts for 71.8 percent(122/170),positive rate of bacillus brevis 79.4 percent(135/170),white blood cells<10 81.2 percent(138/170),and detection rate of epithelial cells 94.1 percent(160/170).Conclusion:Using clue cells as main basis of diagnosis and treat- ment of bacterial vaginal diseases,and marked decrease in lactobacilli constantly existing in vagina as sup- plementary index,reduction in white blood ceils and epithelial cells is related to mycop plasmal infection.