300例阴道分泌物的细菌群体分布状况

Status of vaginal flora distribution in three hundreds female patients

目的了解妇女阴道微生态环境中的细菌群体分布情况。方法对2015年3月份随机在武警总医院第二临床部妇产科就诊的300例妇女的阴道分泌物进行涂片和革兰氏染色，分析其菌群密集度、菌群多样性和优势菌的分布状况。根据油镜下每个视野的平均细菌数把菌群密集度分为Ⅰ～Ⅳ级；根据油镜下每个视野能辨别的细菌种类数把菌群多样性分为Ⅰ～Ⅳ级；视野下所见最多的微生物定义为优势菌。结果在300例阴道分泌物中，正常菌群与异常菌群分别占30.3％和69．7％；菌群密集度以Ⅲ为主，占45．0％；菌群多样性以Ⅱ为主，占61．0％；优势菌以乳杆菌为主，占56．3％。异常菌群包括非乳杆菌优势菌群（主要为革兰阴性杆菌和革兰阳性球菌）、抑制性菌群和过度增殖性菌群，分别占33．0％、29．0％和7．7％。结论阴道微型生态环境中细菌群体的平衡与失调影响着阴道的生理与病理状态，分析阴道分泌物的细菌群体分布特点将为各种阴道炎等妇产科疾病的诊断和治疗提供重要的临床价值。

Objective To investigate the status of flora distribution in the micro ecological environment of vagina in female patients. Methods Vaginal secretions from three hundreds of female patients in the hospital in March,2015 were smeared, stained with Gram and analyzed for flora density,flora diversity and dominant bacteria on the slides. According to the average number of bacteria per field under oil immersion, the flora density was divided from ＋ to ＋＋＋＋; the flora diversity was divided from ＋ to ＋＋＋＋ according to the number of kinds of bacteria per field under oil immersion; the dominant bacteria was the organism which was the most per field under oil immersion. Results Among the three hundreds samples examined, normal flora and abnormal flora accounted for 30.3% and 69.7%, respectively. 45.0% of the flora density were ＋＋＋, 61.0% of the flora diversity were ＋＋, and 56.3% of the major bacteria were lactobacillus. Abnormal flora included non-lactobacillus-dominant-bacteria flora, which mainly consisted of gram-negative rods and gram-positive cocci, inhibitory flora and over-proliferation flora. Conclusions In the micro ecological environment of vagina, the balance and the disorder of flora affected the physiological and pathological status of vagina; analysis of the characteristics of the flora distribution in vaginal secretions played an important role on the diagnosis and therapy of gynecological and obstetrical diseases, such as all kinds of vaginitis.