济南地区14761例妇产科门诊患者阴道微生态评价与分析

Evaluation and analysis of vaginal micro-ecology of 14,761 gynecology and obstetrics outpatient patients in Jinan area

目的分析济南地区某三甲医院妇产科门诊14761例患者阴道微生态结果,了解济南地区女性阴道微生态总体状况,探究形态学与酶功能学联合评价女性阴道微生态的优势。方法选取2021年6月至2022年8月山东第一医科大学附属省立医院就诊的14761例表现为外阴瘙痒、灼痛或刺痛及白带增多有异味等症状的患者作为研究对象。对纳入的研究对象采用形态学及酶功能学检测方法进行全面微生态评价,并对结果进行分析。结果14761例就诊者中,阴道微生态正常者263例,占1.79%;微生态失调者14497例,占98.21%。阴道微生态失调者中,优势菌异常者4696例,占31.82%;清洁度异常者6703例,占45.41%。阴道炎中,需氧菌性阴道炎(AV)2036例,占13.79%;细菌性阴道病(BV)2102例,占14.24%;阴道假丝酵母菌病(VVC)2261例,占15.31%;滴虫阴道炎(TV)124例,占0.84%;混合性感染1345例,占9.11%。阴道微生态酶功能学检测显示各指标阳性率分别为:pH 3624例,占24.55%;过氧化氢5637例,占38.19%;白细胞酯酶13705例,占92.84%;唾液酸酶3709例,占25.13%。结论济南地区女性阴道微生态异常者比例较高,以优势菌异常、清洁度异常为主,阴道炎中VVC发病率最高,对女性进行形态学和酶功能学评价微生态可更好地辅助诊断女性妇科疾病。

Objective To analyze the results of 14,761 patients′vaginal micro-ecology cases in the outpatient department of gynecology and obstetrics of a third-class hospital in Jinan area,to understand the overall situation of female vaginal micro-ecology in this area,and to explore the advantages of the combined evaluation of female vaginal micro-ecology by morphology and enzyme function.Methods A total of 14,761 patients with symptoms of vulva pruritus,burning or stinging pain,increased leucorrhea and odor from June 2021 to August 2022 in Shandong Provincial Hospital Affiliated to Shandong First Medical University were selected as study subjects.A comprehensive micro-ecological evaluation was carried out on the included study subjects by morphology and enzyme function detection methods,and the results were analyzed.Results Among 14,761 patients,263 patients with normal vaginal micro-ecology accounted for 1.79%,14,497 patients with abnormal vaginal micro-ecology accounted for 98.21%.4,696 patients with abnormal dominant bacteria accounted for 31.82%,and 6,703 patients with abnormal cleanliness accounted for 45.41%.Among vaginitis,2,036 cases of aerobic vaginitis(AV)accounted for 13.79%,2,102 cases of bacterial vaginosis(BV)accounted for 14.24%,2,261 cases of vaginal candidiasis(VVC)accounted for 15.31%,124 cases of trichomoniasis vaginitis(TV)accounted for 0.84%,and 1,345 cases of mixed infection accounted for 9.11%.The functional detection of vaginal micro-ecological enzyme showed that the positive rates of various indicators were:pH 3,624 cases(24.55%),hydrogen peroxide 5,637 cases(38.19%),leucocyte esterase 13,705 cases(92.84%),sialidase 3,709 cases(25.13%).Conclusions The proportion of women with abnormal vaginal micro-ecology in Jinan area is relatively high,mainly with abnormal dominant bacteria and cleanliness.Among vaginitis,the incidence rate of VVC is the highest.Combined morphology and enzyme function evaluation of women can better assist in the diagnosis of female gynecological diseases.