妇科门诊174290例妇女阴道微生态状况分析

Analysis on vaginal microecology of 174290 women from gynecological clinic

目的:分析妇科门诊就诊女性阴道微生态特征.方法:选择2012年1月1日-2021年8月30日在本院因外阴瘙痒、白带增多、阴道分泌物异味、外阴灼痛或刺痛就诊的174290例女性,对其阴道微生态结果进行回顾性分析.结果:174290例就诊者中诊断阴道炎45995例(26.4%),包括细菌性阴道炎(BV)23332例(13.4%),外阴阴道假丝酵母菌病(VVC)17753例(10.2%),滴虫性阴道炎(TV)628例(0.4%),VVC+BV3330例(1.9%)和TV+BV952例(0.5%).未诊断阴道炎且菌群正常者中pH值>4.5及清洁度III度分别占菌群正常患者的37.9%和10.7%.菌群抑制、pH值>4.5的非阴道炎患者中,≥50岁占比例高于<50岁者,而清洁度III的≥50岁患者占比低于<50岁者(均P<0.05).结论:妇科门诊有阴道症状就诊者存在不同阴道微生态失调状态;阴道微生态评价能够指导临床医师针对不同年龄患者准确、全面评价阴道微生态状况,减少阴道感染反复发作.

Objective: To analyze the vaginal microecological characteristics of patients from gynecological clinic. Methods: From January 1, 2012 to August 30, 2021, 174,290 patients with symptoms including vulva pruritus, increased leucorrhea, the leucorrhea having unusual smell, or vulva burning or tingling from gynecology outpatients of Peking University Third Hospital were enrolled. The results of vaginal microecology of these patients were analyzed retrospectively. Results: Among 174,290 patients, 45995(26.4%) patients were diagnosed as vaginitis, which included 23 332(13.4%) patients with bacterial vaginitis(BV), 17,753(10.2%) patients with vulvovaginal candidiasis(VVC),628(0.4%) patients with trichomonal vaginitis(TV), 3330(1.9%) patients with VVC combined with BV, and 952(0.5%) patients with TV combined with BV. Among the patients without diagnosed vaginitis and with normal vaginal flora, the percentage of normal pH value >4.5 and cleanliness III of the patients were 37.9% and 10.7%. In addition, the percentages of vaginal flora inhibition and pH value >4.5 of the patients without vaginitis and aged in ≥50 years old were significantly higher than those of the patients aged in <50 years old, while the percentage of vaginal cleanliness III of the patients without vaginitis and aged in ≥50 years old was significantly lower(all P<0.05). Conclusion: The patients with different vaginal symptoms from gynecological clinic have different vaginal microecological disorders. The vaginal microecological evaluation system of the patients can guide clinicians to evaluate the vaginal microecological status accurately and comprehensively, so as to reduce the recurrence of vaginal infection repeatedly.