念珠菌阴道炎合并解脲脲原体的临床研究

摘要

目的 探讨念珠菌阴道炎患者解脲脲原体(Ureaplasma urealyticum,Uu)检测及治疗的临床意义.方法 158例念珠菌阴道炎患者均取宫颈分泌物进行Uu培养及药敏试验.所有患者随机分为A、B组,每组79例.A组为单纯治疗组,局部放置达克宁阴道栓1周,同时口服伊曲康唑胶囊,0.2g/次,1次/d,共1周;B组为混合治疗组:局部放置达克宁阴道栓1周,口服伊曲康唑胶囊,0.2g/次,1次/d,共1周,同时给予Uu敏感药物多西环素片口服,0.1g/次,2次/d,共1周,或者克拉霉素片口服,0.5 g/次,1次/d,共1周;2组患者均在治疗结束两周后复查念珠菌及培养Uu.结果 A、B组治疗前Uu培养的阳性率分别为96.20％、93.67％,治疗结束2周后,Uu培养的阳性率分别为20.45％和14.46％.A组与B组治疗前后Uu阳性率比较x2分别为0.13和0.38,差异无统计学意义(P＞0.05).结论 念珠菌阴道炎合并Uu感染率高,但联合抗Uu药物治疗差异无统计学意义;故Uu培养作为念珠菌阴道炎诊疗过程中常规检测项目的临床意义不大,不推荐念珠菌阴道炎患者常规抗Uu治疗.%Objective To investigate the clinical significance of detection and treatment of Ureaplasma urealyticum (Uu) in the patients with vaginal candidiasis. Methods 158 cases of vaginal candidiasis patients were divided into group A and group B randomly. 79 cases in group A was treated with vaginal suppository (Daktarin, containing miconazole nitrate 200 mg, once daily) plus oral itraconazole 0.2 g, once daily for one week. 79 cases in group B was treated combined with oral doxycycline 0.1 g, twice a day, or oral clarithromycin 0.5 g, once daily for one week. Cervical secretion specimens taken from all the patients were collected and subjected to identification of Candida and Uu before treatment and two weeks after treatment. Results Uu was detected in 96.2% of patients in group A and 93.7% in group B before treatment (χ2=0.13, P>0.05). The rates were decreased to 20.3% in group A and 16.5% in group B two weeks after treatment (χ2=0.38, P>0.05). Conclusion The prevalence of vaginal candidiasis combined with Uu is high. However, detection and treatment of Uu in vaginal candidiasis are not recommended.