27例女性生殖器疱疹患者临床及阴道微生物特点分析

Clinical and vaginal microbiological characteristics of genital herpes in 27 females

目的 了解妇科门诊就诊的女性生殖器疱疹患者临床特点及下生殖道微生态状况,帮助更规范地治疗生殖器疱疹。方法 纳入首都医科大学附属北京妇产医院妇科门诊就诊的27例临床诊断为生殖器疱疹的女性,分析其临床资料及阴道分泌物微生态检查结果。结果 27例女性生殖器疱疹临床表现为不同程度的外阴瘙痒、疼痛、烧灼痛、刺痛等,妇科查体表现从典型的外生殖器疱疹样改变到隐匿的不规则小溃疡,1例表现为宫颈疱疹样改变。24例(88.89%)阴道微生态异常,其中菌群正常功能下降者8例,细菌性阴道病者2例,白假丝酵母菌病6例,菌群异常者7例,混合感染1例。患者阴道分泌物pH值普遍升高,pH值>4.5者共计22例,占比81.48%(22/27)。结论 女性生殖器疱疹患者临床表现多样,且常合并阴道微生态失调。临床上推荐对所有可疑生殖器疱疹的女性进行阴道微生态检查,并进行个体化针对性治疗。

Objective To understand the clinical characteristics and microecological status of lower genital tract in females with genital herpes in gynecological clinic in order to standardize the treatment of genital herpes.Methods A total of 27 women diagnosed with genital herpes were enrolled from the gynecological clinic of Beijing Obstetrics and Gynecology Hospital,Capital Medical University.The clinical data and vaginal microecology of participants were analyzed.Results All patients presented with various degree of external genital itching,pain,burning pain,sting pain,etc.Gynecological examination showed typical external genital herpes and/or irregular small ulcers.One case presented with cervical herpes-like changes.Abnormal vaginal microecology was observed in 88.89%of the patients(24/27),including 8 cases of decreased function of flora,2 cases of bacterial vaginosis,6 cases of vulvovaginal candidiasis,7 cases of abnormal flora,and 1 case of mixed infections.The pH of vaginal secretions was higher,evidenced by 22 cases(22/27,81.48%)with pH>4.5.Conclusions The clinical manifestations of female genital herpes vary and are often accompanied by vaginal dysbiosis.In clinic,it is recommended to conduct vaginal microbiota examination and personalize targeted treatment for all women with suspected genital herpes.