Clinical Analysis of Vaginal Microecology in Patients with Polycystic Ovary Syndrome
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摘要:
目的 对比初诊多囊卵巢综合征(PCOS)患者与健康妇女阴道微生态结果,探讨其PCOS患者发病病因及诊疗思路。 方法 选择80例初诊PCOS患者作为研究组,同期选取体检健康组80例对照组。取两组研究对象阴道分泌物检测滴虫、真菌、菌群密集度、白细胞、优势菌、Nugent评分及AV评分情况。比较两组上述阴道微生态指标,分析两组阴道微生态是否失调。 结果 两组受试者滴虫检出率均为零,两组受试者优势菌、真菌检出率、AV评分、Nugent评分及阴道感染情况比较,差异有统计学意义(P < 0.05)。两组受试者白细胞、菌群密集度比较,差异均无统计学意义(P > 0.05)。 结论 PCOS患者阴道菌群构成与正常阴道微生态环境有明显差异,为治疗PCOS的一种新方案以及动态观察PCOS患者微生态状况可作为评估POCS患者治疗后的一个重要指标。 Abstract:Objective To compare the vaginal microecological results of newly diagnosed patients with polycystic ovary syndrome (PCOS) and healthy women, and to explore the etiology, diagnosis and treatment of PCOS patients. Methods 80 newly diagnosed PCOS patients were selected as the study group, and 80 healthy patients in the physical examination group were selected as the control group. The vaginal secretions of two groups of subjects were tested for trichomonas, fungi, flora density, white blood cells, dominant bacteria, Nugent score and AV score. The above vaginal microecological indicators of the two groups were compared to analyze whether the vaginal microecological disorders of the two groups were imbalanced. Results The detection rate of trichomonas in the two groups of subjects was zero. The comparison of the dominant bacteria, fungus detection rate, AV score, Nugent score and vaginal infection between the two groups was statistically significant (P < 0.05). There was no significant difference in the density of white blood cells and flora between the two groups of subjects (all P > 0.05). Conclusion The composition of the vaginal flora of PCOS patients is significantly different from the normal vaginal microecological environment. It is a new treatment for PCOS and the dynamic observation of the microecological status of PCOS patients can be used as an important indicator for evaluating POCS patients after the treatment. -
Key words:
- Polycystic ovary syndrome /
- Vaginal microecology /
- Flora imbalance /
- Comparative study
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表 1 两组受试者阴道分泌物菌群检出情况比较[n(%)]
Table 1. Comparison of the detection of vaginal secretions between the two groups [n(%)]
组别 例数 白细胞 优势菌 < 10/HP > 10/HP 革兰阳性大杆菌 非革兰阳性大杆菌 对照组 80 68(85.00) 12(15.00) 62(77.50) 18(22.50) 研究组 80 61(76.20) 19(23.80) 44(55.00) 36(45.00) χ2 1.96 9.057 P 0.161 0.003 组别 例数 菌群密集度 真菌检出率 Ⅱ+Ⅲ Ⅰ+Ⅳ 对照组 80 74(92.50) 6(7.50) 3(3.75) 研究组 80 68(85.00) 12(15.00) 14(17.50) χ2 2.25 7.96 P 0.133 0.005 表 2 两组受试者Nugent评分、AV评分及阴道感染情况比较[n(%)]
Table 2. Comparison of Nugent score,AV score and Vaginal infection between the two groups [n(%)]
组别 例数 Nugent评分 AV评分 0-3分 4-6分 ≥7分 < 3分 ≥3分 对照组 80 71(88.75) 9(11.25) 0(0) 76(95) 4(5.00) 研究组 80 59(73.75) 15(18.75) 6(0.75) 65(85.00) 15(18.75) χ2 8.61 7.227 P 0.014 0.007 组别 例数 无感染 阴道感染 单一感染 混合感染 VVC AV BV AV+BV AV+VVC BV+VVC 对照组 80 73(91.25) 3(3.75) 4(5.00) 0(0.00) 0(0.00) 0(0.00) 0(0.00) 研究组 80 53(66.25) 10(12.50) 8(10.00) 1(1.25) 4(5.00) 3(3.75) 1(1.25) Z −3.933 P < 0.001 -
[1] 赵琦, 阳晓敏, 蒋采瑜, 等. 多囊卵巢综合征患者与健康妇女阴道微生态临床特点对比研究[J].中国妇幼保健,2018,33(11):2532-2535. [2] 刘成连, 孙红. 多囊卵巢综合征高雄激素血症中西医治疗进展[J].新疆中医药,2018,36(4):124-127. [3] 赵琦. PCOS人群的阴道微生态研究进展[J].世界最新医学信息文摘,2018,18(11):37-38. [4] 曹敬荣, 王培昌, 闵嵘, 等. 不同年龄段妇女阴道微生态状况分析[J].中华实验和临床感染病杂志(电子版),2016,10(3):311-314. [5] 自蓉, 张洁, 叶珂帆, 等. 外阴疾病患者阴道微生态状况及其影响因素[J].山东医药,2017,57(20):87-89. doi: 10.3969/j.issn.1002-266X.2017.20.029 [6] 冷芹, 魏兆莲. 多囊卵巢综合征病因、发病机制及治疗的最新研究进展[J].国际生殖健康/计划生育杂志,2018,37(1):57-61. doi: 10.3969/j.issn.1674-1889.2018.01.013 [7] Rotterdam EA-SPCWG. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome[J]. Fertil Steril,2004,81(1):19-25. [8] 中华医学会妇产科学内分泌学组及指南专家组. 多囊卵巢综合征中国诊疗指南[J]. 中华妇产科杂志, 2018, 53(1): 2-6. [9] 曾忠铭,潘令嘉,周殿元,等. 临床微生态学及其理论基础[J].中国微生态学杂志,1999,11(6):321-328. [10] 李桂军, 赵蔚, 周建娟. Nugent及Donders评分在细菌性阴道病合并需氧菌性阴道炎患者诊治中的临床应用[J].中国卫生检验杂志,2016,26(9):1270-1272. [11] 中华医学会妇产科学分会感染性疾病协作组. 阴道微生态评价的临床应用专家共识[J].中华妇产科杂志,2016,51(10):721-723. doi: 10.3760/cma.j.issn.0529-567x.2016.10.001 [12] 王辰, 薛凤霞. 阴道微生态评价对需氧菌性阴道炎的诊断作用[J].中国实用妇科与产科杂志,2017,33(8):779-782. [13] 何晓彤, 孟祥雯, 张雪娇, 等. 多囊卵巢综合征病因与发病机制的研究进展[J].中国妇幼保健,2017,32(7):1588-1591. [14] 梁叶萌, 黄礼云. 多囊卵巢综合征中西医诊疗进展[J].世界最新医学信息文摘,2019,19(30):101-102+104. [15] 杨瑞雪, 熊正爱. 阴道微生态平衡影响因素的研究进展[J].检验医学与临床,2018,15(7):1037-1040. doi: 10.3969/j.issn.1672-9455.2018.07.050 [16] 王慧慧, 李焕荣, 马晓彤, 等. 阴道微生态的研究进展[J].中国微生态学杂志,2020,32(4):469-471. [17] 朱英. 多囊卵巢综合征证素与性激素相关性研究[D]. 南京: 南京中医药大学(硕士学位论文), 2015. [18] 丁锦丽. 多囊卵巢综合征的研究进展[J].医学综述,2015,21(6):1050-1053. doi: 10.3969/j.issn.1006-2084.2015.06.035