阴道菌群与细菌性阴道病研究进展

Recent advances in association between vaginal flora and bacterial vaginosis

健康妇女阴道菌群结构以乳酸杆菌为主,以弯曲乳酸杆菌或詹氏乳酸杆菌为优势菌的妇女阴道菌群结构比较稳定,不易出现阴道微生态菌群紊乱和感染等阴道疾患。如果乳酸杆菌的优势地位被大量厌氧菌取代,则会引起细菌性阴道病(bacterialvaginosis,BV),BV患者易出现反复流产、早产等不良妊娠结局,而且感染HIV的风险显著增高。治疗BV主要依靠抗生素,但疗效欠佳且容易复发。在常规抗生素治疗后,再补充从健康妇女阴道分离的优势乳酸杆菌菌株,可防止BV复发。本文就健康育龄妇女阴道菌群的特点及其与BV发病及复发关系的研究进展进行综述,以期为治疗BV复发提供新的方向和靶点。

The vaginal flora in most healthy women is dominated by Lactobacillus species. Vaginal microbial ecosystem domi-nated by Lactobacillus crispatus or Lactobacillus jensenii is stable, and thus abnormalities in vaginal flora, vaginal infections and other kinds of vaginosis are not likely to occur. Depletion of Lactobacilli in the vagina results in bacterial vaginosis （BV）, where the predomi-nated Lactobacillus is replaced by lots of Obligate anaerobes. BV may cause adverse pregnancy outcome such as recurrent abortion and premature labor, and increase the risk for HIV acquisition. The antibiotic treatment for BV is not effective and may be likely to lead to reoccurrence of BV. Research studies have shown that the use of Lactobacillus probiotics isolated from healthy woman can reduce reoc-currence of BV after routine antibiotic treatment. This review focuses on the recent advances in the characteristics of vaginal flora and its association with BV pathogenesis and reoccurrence in healthy women of childbearing age, so as to provide new approaches and targets for the treatment of BV reoccurrence.