细菌性阴道病临床特征及相关危险因素分析

摘要

Objective To evaluate the clinical features and risk factors for bacterial vaginosis. Methods The study was designed as a prospective ease-controlled study. Case group included 150 bacterial vaginasis (BV) patients, and control group consisted of 100 normal women. Results The mean age Of BV was 31.92±9.15. 66.7% of women with bacterial vaginosis noted odor, discharge. Some BV patients (17.3%) are asymptomatic. In 88.7 % of women with bacterial vaginosis, vaginal pH is more than 4.5. Vaginal clean degree is usually grade Ⅰ or grade Ⅱ (90.7%), Out of 14(9.3%) grade Ⅲ～ grade Ⅳ , 4 complicated with vulvovaginal candidiasis, 3 with trichomonal vaginitis, 7 with aerobic vaginitis. The risk factors associated with BV included: Panty liners used during intermenstruation (P =0.016), oral sexual habits (P = 0.003), vaginitis history (P = 0.001). Condom use was a protective factor (P = 0.000). Conclusion The prevalence of bacterial vaginosis is found in women during their reproductive age. Odor or discharge is main complaints, however some women are asymptomatie. Vaginal clean degree is usually grade Ⅰ or grade Ⅱ in BV. ff vaginal clean degree is grade Ⅲ or grade Ⅳ, it suggests that there is a mixed infection. Panty liners used during inter-menstruation, oral sexual habits, vaginitis history are risk factors for BV. Condom use is a protective factor.%目的 探讨细菌性阴道病(BV)的临床特征及相关危险因素,为BV的预防及临床诊治提供帮助.方法 采用前瞻性研究方法,对2008年3～7月天津医科大学总医院妇科收治的150例BV患者及同期100例健康查体妇女进行病例对照研究,记录被研究人群临床资料.结果 BV患者年龄平均(31.92±9.15)岁.白带增多或有异味100例(66.7%),无明显阴道炎症状26例(17.3%).BV阴道pH值>4.5者133例(88.7%).BV阴道清洁度Ⅰ～Ⅱ度136例(90.7%);Ⅲ～Ⅳ度14例(9.3%),其中合并外阴阴道假丝酵母茵性阴道病(VVC)4例,滴虫3例.单因素分析显示,文化程度、非月经期使用护垫、阴道冲洗、阴道炎病史、放置宫内节育器、使用避孕套及口炙与BV有相关性;多因素分析显示非月经期使用护垫(P=0.016)、阴道炎病史(P=0.001)、口交(P=0.003)可增加BV的发生危险;采用避孕套可降低BV的发生危险(P=0.000).结论 BV主要发生于性活跃期育龄妇女.白带增多、有异味是其主要症状,部分患者无明显症状.BV阴道清洁度一般为Ⅰ～Ⅱ度,若为Ⅲ度或Ⅳ度,提示有混合感染的可能.非月经期使用护垫、口交、既往有阴道炎病史是BV发生的高危因素.而避孕套是其保护性因素.