4664例门诊患者阴道微生态特征分析

Characteristics of vaginal microecology in 4,664 outpatients

目的通过分析湖北省妇幼保健院门诊就诊女性阴道微生态的总体状况及各年龄段的分布特征,初步了解湖北地区女性阴道炎的流行现状,为妇产科医生临床工作提供参考。方法选取2020年1月至2022年1月于湖北省妇幼保健院妇产科门诊就诊的女性4664例,按年龄分为7组,对其阴道微生态检测结果进行回顾性分析。结果4664例患者中阴道微生态失衡者共4564例(97.9%),其中镜检没有发现明确病原菌的患者有2677例;镜检发现病原菌的患者有1887例,包括1637例单一性阴道炎和250例混合性阴道炎。单一性阴道炎患者中需氧菌性阴道炎(AV,1017/1637,62.1%)占比最高,其次为外阴阴道假丝酵母菌病(VVC,582/1637,35.6%)。混合性阴道炎患者中AV+VVC(193/250,77.2%)占比最高,其次为AV+细菌性阴道病(27/250,10.8%)和AV+滴虫性阴道炎(24/250,9.6%)。AV、VVC、AV+VVC、单一性阴道炎、混合性阴道炎、阴道清洁度Ⅲ~Ⅳ度、阴道H2O2阳性、阴道pH≥4.6在各年龄组患者中的检出率差异均有统计学意义(均P<0.01)。单一性阴道炎、AV、pH≥4.6在幼女及绝经期女性中检出高率较高,而混合性阴道炎、VVC、AV+VVC、清洁度Ⅲ~Ⅳ在育龄期女性中更常见。结论阴道微生态失衡在妇产科门诊患者中检出率较高,不同年龄段女性阴道微生态异常情况不同,妇产科医生在临床工作中应当重视阴道微生态检测,结合患者的年龄及阴道微生态的具体情况,在针对病原体治疗的同时,积极恢复阴道微生态平衡,避免阴道炎反复发作。

Objective To explore the prevalence of female vaginitis in Hubei by analyzing the general condition of vaginal microecology and the distribution characteristics in women at different ages in the outpatient department of Maternal and Child Health Care Hospital of Hubei,and provide reference for the clinical work of obstetricians and gynecologists.Methods A total of 4,664 female patients from January 2020 to January 2022 in the Department of Obstetrics and Gynecology of the hospital were selected and divided into 7 groups according to age.The results of vaginal microecology were retrospectively analyzed.Results Among the 4,664 patients,there were 4,564 cases(97.9%)of vaginal microecological imbalance,among whom 2,677 cases were not find carrying pathogenic bacteria.Microscopic examination found pathogens in 1,887 cases,including 1,637 cases of single vaginitis and 250 cases of mixed vaginitis.In single vaginitis,aerobic vaginitis(AV,1,017/1637,62.1%)was dominant,followed by vulvovaginal candidiasis(VVC,582/1637,35.6%).In mixed vaginitis,AV+VVC(193/250,77.2%)was dominant,followed by AV+bacterial vaginosis(27/250,10.8%)and AV+trichomoniasis vaginitis(24/250,9.6%).There were significant differences in the detection rates of AV,VVC,AV+VVC,single vaginitis,mixed vaginitis,cleanlinessⅢtoⅣdegree,H2O2 positive,and pH≥4.6 in all age groups(all P<0.01).Single vaginitis,AV and pH≥4.6 were higher in young girls and postmenopausal women,while mixed vaginitis,VVC,AV+VVC,and cleanlinessⅢtoⅣwere more common in women of childbearing age.Conclusion The detection rate of vaginal microecological imbalance is high in gynecological outpatients,and the vaginal microecological abnormalities are different among women of different ages.Gynecologists should attach importance to vaginal microecological detection in clinical work,take into consideration the age of patients and specific situation of vaginal microecology,and actively restore the vaginal microecological balance while treating pathogens to avoid repeated attacks of vaginitis.