4019例妇科门诊不同症状患者阴道微生态状况分析

目的探讨妇科门诊不同症状患者的阴道微生态状况。方法回顾性分析2011年11月至2012年9月西安交通大学医学院第一附属医院妇科门诊因不同症状就诊患者的阴道微生态评价（菌群的密集度、多样性、优势菌、病原菌、AV评分、Nugent评分及五项菌群功能及炎症反应指标）检测结果。结果4019例被检查者平均年龄为33．56岁。其中阴道微生态正常占n70％（28／4019）；阴道微生态失调者占99．30％（3991／4019）；后者包括未明确感染的阴道微生态失调患者占66．36％（2667／4019）；明确感染的阴道微生态失调患者占32．94％（1324／4019）；其中外阴阴道假丝酵母菌病（vulvovaginal candidiasis，VVC）患者占24．33％（978／4019）；需氧菌陛阴道炎（aerobic vaginitis，AV）患者占3．11％（125／4019）；细菌性阴道病（bacterial vaginosis，BV）患者占3．14％（126／4019）；滴虫阴道炎（trichomonas vaginitis，TV）患者占5．15％（207／4019）；混合感染患者占8．31％（110／1324）。优势菌群异常患者占54．32％（2183／4019）。结论妇科门诊中未明确感染的阴道微生态失调患者构成比最高；在明确感染的患者中外阴阴道假丝酵母菌病构成比最高；因此阴道微生态评价成为阴道感染性疾病诊断首选检测方法，在临床诊疗实践中具有重要意义。

Analysis of vaginal micro-ecological status in 4019 clinical patients with different symptoms

Objective To investigate vaginal micro-ecological status in gynecological outpatients with different symptoms. Methods Retrospective analysis the results of the vaginal micro-ecological evaluation in gynecological outpatients with different symptoms from November 2011 to September 2012 （ The index include intensity and di- versity of bacteria group, dominant flora, pathogens, AV score, Nugent score and five bacteria function and inflammation index）. Results The average age of 4019 patients was 33.56. The normal vaginal micro-ecological patients was 0. 70% （28/4019） ; the patients with vaginal micro-ecological disorder was 99. 30% （3991/4019） ; the latter included ill-defined infected vaginal micro-ecological disorder （66. 33 % , 2666/4019 ）, and defined infected vaginal micro-ecological disorder （32. 97%, 1324/4019）. In patients with defined infected vaginal micro-ecological disorder, VVC was 24. 33% （978/4019） ; AV was 3.11% （125/4019） ; BV was 3.14% （126/4019） ; TV was 5.15% （207/4019）, and mixed infection was 8.31% （110/1324）. Abnormal dominant flora was 54. 32% （2183/4019）. Conclusion In gynecological outpatients, the constituent ratio of patients with ill-defined infected vaginal micro-ecological disorder is highest; in defined vaginal infections patients, the constituent ratio of vulvo- vaginal candidiasis is highest; becoming the preferred diagnosis method of vaginal infection disease, the vaginal micro-ecological evaluation is of great significance in the clinical diagnosis and treatment practice.