22 029例门诊妇女阴道微生态的特征分析

Analysis on vaginal micro-ecology of 22 029 outpatients

摘要:

目的：分析门诊妇女阴道微生态特征，对临床诊疗提供指导。方法：选取2015年1月至2015年12月门诊就诊妇女22 029例，对其阴道微生态状况（阴道pH、乳杆菌、清洁度等）进行回顾性分析。结果：①22 029例就诊者中阴道微生态正常者3 219例（14.61%），阴道微生态异常者18 810例（85.39%）。阴道微生态异常中优势菌异常9 443例（9 443/18 810，50.20%），单纯性阴道炎6 138例（6 138/18 810，32.63%），混合性阴道炎1241例（1 241/18 810，6.60%）。单纯性阴道炎以细菌性阴道炎（bacterial vaginosis，BV）为主（3 237/6 138，52.74%），其次为外阴阴道假丝酵母菌病（vulvovaginal candidiasis，VVC）（2 455/6 138，40.00%）。混合性阴道炎以BV+VVC为主（321/1 241，25.87%），其次为需氧菌性阴道炎（aerobic vaginitis，AV）+VVC（268/1 241，21.60%）。②不同年龄段各类阴道炎的构成比不同，其中混合性阴道炎中，AV+VVC的构成比50岁后各年龄段较21~50岁年龄段明显下降（P=0.00）。③乳杆菌数量与阴道pH密切相关（P=0.00）。结论：阴道微生态异常在妇科门诊患者发生率高，有明确病原菌诊断的部分患者存在混合感染，不同年龄段阴道微生态异常构成比不同，提示对阴道炎的治疗中应结合患者年龄及阴道微生态状态，在杀病原体的同时注意恢复阴道微生态平衡，防止阴道炎的反复发作。

Abstract:

Objective：To provide guidance for clinical diagnosis and treatment by analyzing the characteristics of female vaginal mi－cro-ecology in the outpatients. Methods：Conducting a retrospective study by analyzing the women who took vaginal micro-ecological detection in the hospital from January 2015 to December 2015. The contents of the vaginal micro-ecology was analyzed mainly in－cluding vaginal pH，lactobacillus and cleanliness. Results：①The vaginal micro-ecology of 3 219（14.61%） patients was normal；how－ever，the other 18 810 patients（85.39%） were abnormal including dominant flora in 9 443 cases（9 443/18 810，50.20%），the simple coleitise in 6138 cases（6 138/18 810，32.63%）and the mixed coleitise in 1 241 cases（1 241/18 810，6.60%）. The bacterial vaginosis （BV） occupied for 52.74%（3 237/6 138），which is the most common type among the simple coleitis. The vulvovaginal candidiasis （VVC） occupied for 40.00%（2 455/6 138）. The BV and VVC occupied for 25.87%（321/1 241），which is common in the mixed coleitis，followed by aerobic vaginitis（AV） and VVC（268/1241，21.60%）. ②Vaginitis is closely related to age. It was found that the constituent ratio of AV+VVC over 50-year-old is significantly lower than that of group of 21 to 50 years old（P=0.00）. ③The number of lactobacillus is closely related to the pH of vagina（P=0.00）. Conclusion：The incidence rate of abnormal vaginal micro-ecological is high in outpatients. Some patients with definitive diagnosis for pathogenic bacteria have mixed infection. Different age groups have different constitutions of vaginal micro-ecological. We should combine the age of patients with vaginal micro-ecological status in the treatment of coleitis. When taking sterilization，we also should restore the balance of vaginal micro-ecological at the same time pre－venting coleitis happening repeatedly.