阴道微生态失调与不同年龄妇科相关疾病及状态的关系调查

Investigation on the relationship between vaginal microecological disorders and gynecological diseases and their status in women of different ages

目的通过门诊调查探讨女性阴道微生态失调与不同年龄妇科相关疾病和状态的关系。方法回顾性分析2016年7月至9月在南京市栖霞区妇幼保健院妇产科门诊就诊的女性患者1 499例(包括常规妇科检查、人工流产前、安环前和取环前等常规实行白带检查者)的临床资料。取患者阴道分泌物,作常规镜检和应用细菌性阴道病(BV)六联检测试剂分析其阴道微生态状况(包括致病菌、优势菌、清洁度、功能状态等),并结合相关临床疾病进行分析。结果 1 499例(100.00%)女性都存在不同程度的阴道微生态失调,其中阴道炎416例(27.75%),其他微生态失调1 083例(72.25%,包括月经失调77例,宫颈炎性疾病51例,盆腔炎48例等疾病和常规妇科检查300例,其他172例,妊娠状态120例,产褥期119例,流产100例,分娩96例等状态)。416例阴道炎患者中,细菌性阴道病111例(26.68%),阴道假丝酵母菌病86例(20.67%),滴虫感染21例(5.05%),混合性阴道炎198例(47.60%)。阴道微生态失调年龄主要集中于20~29岁组(45.56%)、30~39岁组(33.42%)和40~49岁组(11.34%);阴道炎在不同年龄段的发病率随年龄递增明显递升,差异有统计学意义(P<0.01),≥60岁组最高,达78.57%。结论正常女性阴道内环境基本都处于轻度的阴道微生态失调,同时会导致不同程度的相关疾病,而育龄妇女阴道微生态失调较为明显。加强女性阴道微生态的监测对于维持女性生殖道的健康十分必要。

Objective To explore the relationship between vaginal microecological disorders and gynecological diseases and their status in women of different ages through outpatient investigation.Methods A retrospective analysis was made of the clinical data of 1 499 women(including routine gynecological examinations,pre-abortion,pre-annulus and pre-annulus removal) who visited the gynecological and obstetric clinic of Qixia District Maternal and Child Health Hospital in Nanjing from July to September 2016.The vaginal secretions of the patients were taken for routine microscopic examination and the vaginal microecological status(including pathogenic bacteria,dominant bacteria,cleanliness and functional status) was analyzed by using six detection reagents of bacterial vaginosis(BV),and the related clinical diseases were also analyzed.Results Various degrees of vaginal microecological disorders were found in 1 499(100.00%)women,and among them,416(27.75%) had vaginitis,1 083(72.25%) had other microecological disorders,including 77 cases of menstrual disorders,51 cases of cervicitis and 48 cases of pelvic inflammation and 300 cases of routine gynecological examinations,172 other cases,120 cases of pregnancy,119 cases of puerperium,100 cases of abortion,96 cases of childbirth.In the 416 patients with vaginitis,there were 111 cases(26.68%) of bacterial vaginal(BV),86 cases(20.67%) of vulvovaginal candida(VVC),21 cases(5.05%) of trichomonas infection and 198 cases(47.60%) of mixed vaginitis.The age of vaginal microecological disorder was mainly concentrated in 20-29 years old group(45.56%),30-39 years old group(33.42%) and 40-49 years old group(11.34%).The incidence of vaginitis in different age groups increased significantly with the increase of age(P<0.01).The highest incidence was 78.57% in group over 60 years old.Conclusions Normal women′s vaginal environment is basically in a mild vaginal microecological imbalance,which can lead to different degrees of related diseases,while the vaginal microecological imbalance is more obvious in women of childbearing age.Strengthen the monitoring of vaginal microecology for sustaining the health of female genital tract is necessary.