阴道唾液酸酶检测在细菌性阴道病及绒毛膜羊膜炎诊断中的价值

Relationship between vaginal sialidase bacteria vaginosis and chorioammionitis

目的 探讨阴道唾液酸酶的检测在诊断细菌性阴道病及预测绒毛膜羊膜炎中的价值。方法 采用比色法对患细菌性阴道病孕妇 80例 (研究组 ) ,健康孕妇 6 0例 (对照组 )进行阴道唾液酸酶的检测 ,蓝色表示唾液酸酶阳性 ,颜色不变为阴性。绒毛膜羊膜炎的诊断以病理检测为准。结果 研究组孕妇中阴道唾液酸酶阳性率为 96 3% (77 80 ) ,明显高于对照组的 3 3% (2 6 0 ) ,两组比较 ,差异有极显著性 (P <0 0 0 1)。两组中阴道唾液酸酶阳性孕妇的绒毛膜羊膜炎、胎膜早破、早产及产褥感染的发生率分别是 2 6 6 %、39 2 %、2 1 5 %和 16 5 % ,明显高于阴道唾液酸酶阴性孕妇的 4 9%、9 8%、6 6 %和 3 3% ,两者比较 ,差异均有显著性 (P <0 0 1或P <0 0 5 )。阴道唾液酸酶预测绒毛膜羊膜炎的敏感性为 87 5 % (2 1 2 4 ) ,特异性为 5 0 0 % (5 8 116 )。结论 阴道唾液酸酶检测在细菌性阴道病中的阳性率高 ,尤其适用于孕期筛查 ;同时在早期预测绒毛膜羊膜炎等不良妊娠结局的发生中也有一定的实用价值。

Objective To study the relationship among vaginal sialidase,bacterial vaginosis (BV), chorioammionitis and subsequent adverse outcome of pregnacy. Methods Vaginal sialidase was measured by colorimetry in samples of vaginal discharges from 80 pregnant women with BV(study group) and 60 normal pregnant women at same gestation weeks (control group). Color turning blue means positive of sialidase activity, and no color changing means negative. The diagnosis of chorioammionitis was based on pathological examination. Results Nitety six dot three percent, 3.3% exhibited sialidase activities in study group and control group,respectively.There were significant differences between these two groups ( P <0.001). By measuring vaginal sialidase activity, the sensitivity, specificity, positive and negative predictive value in diagnosing BV were 96.3%, 96.7%, 97.5% and 95.1%, respectively. Chorioammionitis, premature rupture of membranes, premature delivery and puerperal infection in sialidase positive group were significantly higher than the negative group. Sensitivity, speciality of sialidase activity for chorioammionitis were 87.5%, 50.0%, respectively. Conclusion Vaginal sialidase activity has strong relation with bacterial vaginosis. Measuring vaginal sialidase activity is a fast, easy, and useful method to diagnose bacterial vaginosis. It also has relation with chorioammionitis and subsequent adverse outcome of pregnancy.