快速青春发育期女性外阴阴道感染特征分析

Analysis on Characteristics of Vulvo-vaginal Infection of Patients in Rapid Puberty

目的:探讨9~13岁快速青春发育期女性外阴阴道感染特征。方法:回顾性分析390例2015年7月至2018年6月在四川大学华西第二医院就诊的9~13岁快速青春发育期女性外阴阴道感染状况,并按年龄分为9岁、10岁、11岁、12岁、13岁5个年龄组。采用χ^2检验分析其假丝酵母菌外阴阴道病(VVC)总发生率、细菌性阴道病(BV)发生率、炎症反应率、优势菌异常率,及不同年龄组上述四者的差异。结果:研究对象中BV发生率、VVC总发生率、炎症反应率、优势菌异常率分别为:37.95%、19.24%、16.15%、8.21%,BV发生率显著高于VVC总发生率,差异有统计学意义(P<0.05)。VVC中白假丝酵母菌和非白假丝酵母菌阳性检出率分别为:15.39%、3.85%,两者比较差异有统计学意义(P<0.05)。5组间经两两比较,发现不同年龄组BV发生率和炎症反应率差异无统计学意义(P>0.05);9岁组VVC总发生率(7.56%)显著低于其他年龄段组(分别为20.75%、29.51%、25.42%、24.44%),差异有统计学意义(P<0.05);10岁组优势菌异常率(12.26%)显著高于13岁组(4.44%),差异有统计学意义(P<0.05)。乳杆菌数量1+/油镜随年龄增长呈下降趋势,而乳杆菌3+~4+/油镜随年龄增长呈上升趋势。结论:快速青春发育期女性外阴阴道感染好发BV和VVC,且BV比VVC更易感,而VVC中以白假丝酵母菌感染为主;9岁女性VVC总发生率最低;10岁女性优势菌异常率高于13岁,波动尚无规律。乳杆菌数量随年龄增长呈规律性增加。

Objective:To explorethe characteristics of vulvo-vaginal infection of 9 to 13 years old female patients in rapid puberty.Methods:390 cases of 9 to 13 years old female patients in rapid puberty with vulvo-vaginal infectionin West China Second University Hospital,Sichuan University from July 2015 to June 2018 were analyzed retrospectively.All these female patients were divided into 5 groups,including groups of 9,10,11,12 and 13 years old.The incidence of Vulvo-vaginal candidiasis(VVC),and bacterial vaginosis(BV),inflammatory response rate,abnormal dominant bacteria rate,and their differences with in groups were analyzedbyχ^2 test.Results:In the 390 cases of 9-13 years old females in rapid puberty,the incidence of BV and VVC vaginal inflammatory response rate and abnormal dominant bacteria rate were 37.95%,19.24%,16.15%and 8.21%,respectively.The incidence of BV was significantly higher than that of VVC(P<0.05).For VVC,the positive detection rates of Candida albicans and non-albicans Candida were 15.39%and 3.85%.The difference was statistically significant(P<0.05).With multiple comparisons,there was no significant difference in BV incidence and inflammatory response rate for patients with different ages(P>0.05).VVC incidence of 9-year-old group(7.56%)was significantly lower than that of other groups(20.75%,29.51%,25.42%,24.44%,respectively)and the difference was statistically significant(P<0.05).The abnormal dominant bacteria rate of 10-year-old group(12.26%)was significantly higher than that of 13-year-old group(4.44%)and the difference was statistically significant(P<0.05).The number of Lactobacillus 1+/oil mirrors decreased with ages,while Lactobacillus 3+~4+/oil mirrors increased with ages.Conclusions:BV and VVC are common in females in rapid puberty,in which BV is more common.Candida albicans is the main infection in VVC.The incidence of VVC is the lowest in 9-year-old group.The abnormal dominant bacteria rate was higher in the 10-year-old group that that in the 13-year-old group,which could not be explained.The number of lactobacilli increased regularly with ages.