合肥市孕期妇女阴道分泌物湿片镜检与五项生化检验结果分析

Results of the routine tests and five biochemical detections for vaginal secretions in pregnant women in Hefei

目的探查合肥地区孕期妇女生殖道感染特点,为临床诊断提供参考。方法选取2017年11月-2018年9月来我院行孕期检查的孕妇969例,采集阴道分泌物分别进行镜检和五联检法联合检测,分析孕妇分泌物清洁度及病原结果。结果 969例孕妇阴道分泌物中,正常清洁度(Ⅰ~Ⅱ)占标本总数36.22%,病原体检出率6.84%,异常清洁度(Ⅲ~Ⅳ)占标本总数63.78%,病原体检出率44.66%,不同清洁度病原体检出率差异有统计学意义(Ps<0.05)。病原体阳性者300例,其中真菌感染158例(16.31%),细菌感染157例(16.20%),毛滴虫感染5例(0.52%),混合感染20例(2.06%)。清洁度Ⅰ~Ⅱ度白细胞酯酶、唾液酸苷酶、脯氨酸氨基肽酶阳性率分别为17.23%、0.52%、0.93%,清洁度Ⅲ~Ⅳ度白细胞酯酶、唾液酸苷酶、脯氨酸氨基肽酶阳性率分别为61.40%、8.36%、17.34%,检测结果差异有统计学意义(Ps<0.05)。结论合肥地区孕妇阴道分泌物病原体检出率较高,湿片镜检和五联检法联合检测可提高阴道炎诊断的准确性,在临床工作中应加强对孕期妇女的健康指导及生殖道感染的监测,做到早发现、早诊断、早治疗。

Objective To explore the distribution and clinical characteristics of reproductive tract infection in pregnant women in Hefei.Methods A total of 969 pregnant women who received prenatal examination in our hospital during November 2017 to September 2018 were selected.The vaginal secretion samples were tested using conventional wet mount examination and joint detection of five indicators.Results The detection rate of reproductive tract infection in pregnant women was 30.96%(300/969).The detection rate of normal cleanliness(Ⅰ-Ⅱ)was 36.22%(351/969),with the pathogen infection rate of 6.84%(24/351).The detection rate of abnormal cleanliness(Ⅲ-Ⅳ)was 63.78%(618/969),with the pathogen infection rate of 44.66%(276/618).The level of pathogen infection in abnormal cleanliness group was significantly higher than that in normal cleanliness group(P<0.05).Among the infection cases,candidal infection accounted for 16.31%(158/969),bacterial vaginitis accounted for 16.20%(157/969),trichomonas infection accounted for 0.52%(5/969)and mixed infection accounted for 2.06%(20/969).The positive rates of leukocyte esterase,sialidase and proline aminopeptidase were 17.23%,0.52%and 0.93%respectively in the group of normal cleanliness versus 61.40%,8.36%and 17.34%in the group of abnormal cleanliness;The difference was statistically significant(Ps<0.05).There was no significant difference in the detection rate in each age group between candidal infection and bacterial vaginitis(Ps>0.05).Conclusion The detection rate of pathogen in the vaginal secretions of pregnant women in Hefei is high.Wet mount examination combined with joint detection of five indicators can improve the accuracy of the diagnosis of vaginitis.Monitoring and education on genital tract health of pregnant women should be strengthened in the future to achieve early detection,diagnosis and treatment.