不孕癥女性陰道微生態狀況分析

秦曉梅 孫成華

【摘要】目的：觀察不孕女性陰道微生態和陰道菌群狀況，探討不孕癥女性進行陰道微生態和菌群評價的臨床價值。方法：收集本院收治不孕癥女性150例，同期100例育齡期體檢健康婦女作為對照組；比較兩組陰道分泌物的微生態狀況和Nugent評分；采取細菌培養法檢測兩組陰道分泌物菌群分布。結果：對照組和不孕組在陰道分泌物的多樣性、密集度、優勢菌、pH值以及清潔度方面，比較差異均無統計學意義（P>0.05）。對照組和不孕組的陰道分泌物Nugent評分在≥7分、4～6分和0～3分三個層次比較，差異均無統計學意義（P>0.05）。對照組和不孕組在培養菌群金黃色葡萄球菌、大腸艾希氏菌、腸桿菌、酵母樣菌和表皮葡萄球菌的檢出率比較，差異均無統計學意義（P>0.05）。兩組清潔度異常者革蘭陽性球菌、革蘭陰性桿菌、革蘭陰性球菌、革蘭陰性雙球菌、霉菌、滴蟲、加德納菌檢出率比較差異均無統計學意義（P>0.05）。結論：不孕癥女性和育齡期健康女性的陰道微生態狀況、BV患病率以及陰道菌群分布方面比較無顯著性差異。

【關鍵詞】不孕癥；陰道微生態；陰道菌群；Nugent評分

Analysis of vaginal microflora and micro ecological condition in infertility femaleQIN Xiaomei1， SUN Chenghua2. 1.Department of Obstetrics and Gynecology， Fuling District Peoples Hospital， Chongqing 408000， China；2.Anesthesiology Department， Fuling Central Hospital， Chongqing 408000， China

【Abstract】Objectives： To observe the vaginal microflora and micro ecological condition in infertility female and discuss its clinical value. Methods： 150 infertile female patients in our hospital were selected as infertility group and 100 healthy women of child-bearing age as control group. Vaginal micro ecological conditions and scores of Nugent were compared between the two groups. Distributions of vaginal microflora were detected by bacterial culture method in two groups. Results： No statically significant differences were observed in intensity， diversity， advantage bacterium， pH value and cleanliness of vaginal secretion between the two groups （P>0.05）. No statistically significant difference were observed it scores of Nugent in vaginal secretion at three levels of ≥7 scores， 4～6 scores and 0～3 scores between the two groups （P>0.05）. No statically significant differences were observed in detection rate of bacteria of staphylococcus aureus， Escherichia coli， enteric bacilli， saccharomycopsis and staphylococcus epidermidis between the two groups （P>0.05）. Furthermore， there was no statistically significant difference in relevance ratio of gram positive coccus， gram negative bacilli， gram negative bacteria， gram-negative diplococcus， mould， trichomonad， and gardnerella for cleanliness anomal between the two groups （P>0.05）. Conclusions： Vaginal micro ecological condition， morbidity of BV and distribution of vaginal pathogenic bacteria show no significant difference between infertile female and normal ones.

【Key words】Infertility； Vaginal micro ecological condition； Vaginal microflora； Scores of Nugent

【中圖分類號】R711.6【文獻標志碼】A

女性陰道微生態體系由陰道解剖構造、陰道微生態菌群以及內分泌系統的調節功能組成。健康女性陰道內存在著不同種類的微生物群落，如乳酸桿菌、酵母菌以及大腸埃希菌等，這些菌落與集體環境間相互協調、相互制約，對陰道正常微生態和菌群的維持發揮了關鍵作用[1，2]。

目前，女性不孕癥是臨床常見病，伴隨工作壓力的增加、社會環境的變化以及性病發病率增多，女性不孕癥呈逐年增高趨勢[3]。研究證實，陰道感……