4630例绝经后妇女阴道微生态状况分析

Analysis of vaginal microecology in 4,630 postmenopausal women

目的分析绝经后妇女阴道微生态状况,为临床诊疗提供实验室依据。方法以2018年1月至2019年9月在我院妇科门诊就诊的4630例绝经后妇女作为研究对象,对其阴道微生态检查结果进行回顾性分析。结果4630例患者中阴道微生态正常者409例(8.83%),阴道微生态异常者4221例(91.17%)。阴道微生态异常者中不能通过镜检明确病原菌者1758例(37.97%),包含优势菌异常1406例(30.37%)、菌群抑制351例(7.58%)、菌群增殖过度1例(0.02%);通过镜检明确病原菌者2463例(53.20%),包含细菌性阴道病(BV)1237例(26.72%)、需氧菌性阴道炎(AV)1001例(21.62%)、外阴阴道假丝酵母菌病(VVC)159例(3.43%)、滴虫性阴道炎(TV)66例(1.43%)。不同年龄段绝经后妇女阴道微生态构成存在差异,其阴道清洁度(Ⅲ/Ⅳ)、菌群密集度(未见/Ⅰ)、菌群密集度(Ⅳ)、菌群多样性(未见/Ⅰ)、菌群多样性(Ⅳ)、优势菌(无)、优势菌(G^+大杆菌)、优势菌(G^-弧形菌)、优势菌(G^+球菌)、VVC、TV、β-氨基半乳糖苷酶(+)、唾液酸苷酶(+)、过氧化氢(+)、阴道pH>4.5、微生态异常发生率在不同年龄段之间的分布差异均有统计学意义(均P<0.05)。结论阴道微生态异常在妇科门诊绝经后妇女中发生率较高,且不同年龄段妇女阴道微生态异常构成存在差异,提示应结合年龄治疗阴道疾病,同时积极恢复阴道微生态环境。

Objective To analyze the vaginal microecology of postmenopausal women and provide laboratory basis for clinical diagnosis and treatment.Methods A total of 4,630 postmenopausal women who were treated in our gynecological outpatient department from January 2018 to September 2019 were enrolled,and the results of vaginal microecology examination were analyzed retrospectively.Results A total of 409 patients(8.83%)were normal for vaginal microecology while 4,221 patients(91.17%)were abnormal.Among those with abnormal vaginal microecology,1,758 cases(37.97%)had no confirmed pathogens by microscopy,including 1,406 cases(30.37%)of abnormal dominant flora,351 cases(7.58%)of floral inhibition and 1 case(0.02%)of floral over-proliferation;2,463 cases(53.20%)had confirmed pathogens by microscopy,including 1,237 cases(26.72%)of BV,1,001 cases(21.62%)of AV,159 cases(3.43%)of VVC,and 66 cases(1.43%)of trichomonas vaginitis(TV).There was difference in the composition of vaginal microecology among postmenopausal women of different ages.There were significant differences in the distribution of cleanliness(III/IV),flora intensity(not seen/I),flora intensity(IV),flora diversity(not seen/I),flora diversity(IV),dominant flora(-),dominant flora(G^+bacilli),dominant flora(G^-vibrio),dominant flora(G+cocci),VVC,TV,β-galactosaminidase(+),sialidosidase(+),hydrogen peroxide(+),pH>4.5 and microecological abnormality rate among different age groups.Conclusion The incidence rate of abnormal vaginal microecology is high in postmenopausal women.There are differences in the composition of vaginal microorganisms in postmenopausal women of different ages,suggesting that vaginitis should be treated in consideration with age.