光滑念珠菌导致的外阴阴道假丝酵母菌病的临床特征分析

Analysis of clinical features of vulvovaginal candidiasis caused by candida glabrum

目的评估光滑念珠菌导致的外阴阴道假丝酵母菌病的临床特征。方法选取257例门诊阴道炎患者,根据真菌培养结果分为光滑念珠菌组(36例)与白色念珠菌组(221例)。比较两组患者的临床特征。结果光滑念珠菌组患者外阴无瘙痒、轻度瘙痒、中重度瘙痒的发生率分别为2.8%、91.7%、5.6%,白色念珠菌组患者外阴无瘙痒、轻度瘙痒、中重度瘙痒的发生率分别为7.7%、67.0%、25.3%,光滑念珠菌组外阴瘙痒程度轻于白色念珠菌组,差异具有统计学意义(P<0.05)。两组患者念珠菌病的外阴、阴道瘙痒特点不分昼夜、白天为主、黑夜为主构成比比较,差异无统计学意义(P>0.05)。光滑念珠菌组患者外阴、阴道体征正常、充血水肿占比分别为88.9%、11.1%,白色念珠菌组患者外阴、阴道体征正常、充血水肿占比分别为33.0%、67.0%,光滑念珠菌组患者外阴、阴道体征正常占比高于白色念珠菌组,差异有统计学意义(P<0.05)。光滑念珠菌组阴道分泌物颜色黄白色、灰白色、黄绿色占比分别为66.7%、33.3%、0,白色念珠菌组阴道分泌物颜色黄白色、灰白色、黄绿色占比分别为62.4%、31.2%、6.3%,两组患者阴道分泌物颜色情况比较,差异无统计学意义(P>0.05)。光滑念珠菌组患者的阴道分泌物形状糊状、豆腐渣占比分别为97.2%、2.8%,白色念珠菌组患者的阴道分泌物形状糊状、豆腐渣占比分别为48.9%、51.1%,两组患者阴道分泌物形状比较,差异有统计学意义(P<0.05)。结论光滑念珠菌导致的外阴阴道假丝酵母菌病的主要表现为外阴、阴道瘙痒,瘙痒特点为不分昼夜或白天为主,外阴阴道无明显充血水肿,分泌物为糊状。临床医师需警惕缺乏典型念珠菌感染症状的患者,必要时需排除光滑念珠菌感染的可能。

Objective To evaluate the clinical features of vulvovaginal candidiasis caused by candida glabrum.Methods 257 outpatient patients with vaginitis were selected and divided into the candida glabra group(36 cases)and the Candida albicans group(221 cases)according to the results of fungal culture.The clinical features of the two groups were compared.Results The incidence of vulvar pruritus free,mild pruritus,moderate and severe pruritus in Candida glabra group was 2.8%,91.7%and 5.6%,respectively;the incidence of vulvar pruritus free,mild pruritus,moderate and severe pruritus in Candida albicans group was 7.7%,67.0%and 25.3%,respectively.The degree of vulvar pruritus in Candida glabra group was less than that in Candida albicans group.The difference was statistically significant(P<0.05).There was no significant difference in vulvovaginal pruritus between the two groups(P>0.05).Normal vulvar and vaginal signs and hyperemia edema accounted for 88.9%and 11.1%of patients in the Candida albicans group,and normal vulvar and vaginal signs and hyperemia edema accounted for 33.0%and 67.0%of patients in the Candida albicans group,respectively.The proportion of patients in the candida albicans group with normal vulvar and vaginal signs was higher than that in the Candida albicans group.The difference was statistically significant(P<0.05).The percentages of vaginal secretions in the Candida glabria group were 66.7%,33.3%,and yellow-green,respectively.The percentages of vaginal secretions in the Candida albicans group were 62.4%,31.2%,and 6.3%,respectively.There was no significant difference(P>0.05).The proportion of vaginal secretions in the smooth Candida group was 97.2%and 2.8%,respectively,while the proportion of vaginal secretions in the Candida albicans group was 48.9%and 51.1%,respectively.The difference in the shape of vaginal secretions between the two groups was statistically significant(P<0.05).Conclusion The main manifestation of vulvovaginal candidiasis caused by Candida glabria is vulvovaginal pruritus,pruritus is characterized by day and night or daytime,vulvovaginal no obvious congestive water species,secretions are mushy.Clinicians should be alert to patients lacking typical candida infection symptoms and rule out Candida glabra infection if necessary.