孕妇和育龄妇女阴道微生态及影响因素分析

摘要

目的：探讨孕妇和育龄妇女阴道微生态的状况并分析相关影响因素，为临床预防和控制妇女阴道菌群失衡提供依据。方法选择某医院门诊2011年1月至2012年12月育龄妇女1500例，为育龄组，妊娠妇女1200例为妊娠组，对阴道分泌物微生态及相关指标进行检测。结果妊娠组菌群正常为62．50％（750/1200），高于育龄组的55.93％（839/1500），差异有统计学意义（P＜0．05）；妊娠组细菌性阴道病检出率8．50％（348/1200），低于育龄组的11.93％（179/1500）（P＜0．05）；妊娠组pH为4．22±0．77，低于育龄组的4．62±0．84（P＜0．05）；妊娠组H2O2和白细胞酯酶阳性率分别为（2．51±0．49）μmol/L和8．42％（101/1200），育龄组为（2．28±0．41）μmol/L和11．20％（165/1500），差异有统计学意义（P＜0．05）；妊娠组FSH和E2分别为（13．58±3．63） U/L和（421．09±42．47）pmol/L，均高于育龄组（P＜0．05）；妊娠组乳酸杆菌检出率为39.58％（475/1200），高于育龄组的34．87％（523/1500）（P＜0．05）；妊娠组大肠埃希菌和支原体分别为11．33％（136/1200）和10．08％（121/1200），均低于育龄组（P＜0．05）；妊娠组乳酸杆菌强度大于育龄组（P＜0.01）。结论妊娠组雌激素水平较育龄组高，阴道乳酸杆菌数量多于育龄组，pH值升高，阴道微生态好于育龄组。%Objective To explore the vaginal microecosystem and influence factors of pregnant women and women of childbearing age, and to provide basis for clinical prevention and control of their flora imbalance.Methods We selected 1 500 women of childbearing age as childbearing age group and 1 200 pregnant women as pregnancy group in our hospital from January 2011 to December 2012.We measured the vaginal microecosystem and the related indexes were detected.Results The normal flora of the pregnancy group was 62.50% ( 750/1 200), which was higher than that of the childbearing age group 55.93%(839/1 500) (P<0.05).BV of the pregnancy group was 8.50%(348/1 200), lower than that of the childbearing age group 11.93%(179/1 500) (P<0.05).The pH of the pregnancy group was 4.22±0.77, lower than that of the childbearing age group 4.62±0.84 (P<0.05).H2O2 and the positive rate of white blood cells in the pregnancy group were(2.51 ±0.49)μmol/L and 8.42%(101/1 200), and those of the childbearing age group were(2.28 ±0.41)μmol/L and 11.20%(165/1 500), the difference was significant (P<0.05).FSH and E2 in the pregnancy group were(13.58 ±3.63)U/L and (421.09 ±42.47) pmol/L, which were higher than those of the childbearing age group (P<0.05).Lactobacillus of pregnancy group was 39.58%(475/1200), was higher than that ofthe childbearing age group 34.87%(523/1 500) (P<0.05).Escherichia coli and Myco-plasma of pregnancy group were 11.33%(136/1 200) and 10.08% (121/1 200), which were lower than those of the child-bearing age group (P<0.05). The lactobacillus intensity in pregnancy group was higher than that of the childbearing age group (P<0.01).Conclusion Estrogen levels of pregnancy group was higher than that of the childbearing age group,the number of vaginal lactobacillus was higher than that of the childbearing age group and pH was higher, and the vaginal microecology of preg-nancy group was better than those of the childbearing age group.