复发性外阴阴道念珠菌病的阴道微生态特征分析

中国真菌学杂志　 2015, Vol. 10 　Issue (4): 210-215.

复发性外阴阴道念珠菌病的阴道微生态特征分析

范娟¹, 沈健², 蒋建华¹, 刘延²

1. 上海浦东新区公利医院皮肤科, 上海 200135;
2. 上海交通大学附属瑞金医院妇产科, 上海 200025

收稿日期:2015-06-12 出版日期:2015-08-28 发布日期:2015-08-28
通讯作者: 刘延,E-mail:ly10309@rjh.com.cn E-mail:ly10309@rjh.com.cn
作者简介:范娟,女(汉族),硕士,主治医师.E-mail:fjpitang@126.com

The vaginal bacteria and micro-ecology features in women with recurrent vulvovaginal candidiasis

FAN Juan¹, SHEN Jian², JIANG Jian-hua¹, LIU Yan²

1. Department of Dermatology, Gongli hospital, Second Military Medical University, Shanghai 200135;
2. Department of Gynaecology and Obstetrics, Shanghai Ruijin Hosipital affiliated Shanghai Jiaotong University School of Medicine, Shanghai 200025

Received:2015-06-12 Online:2015-08-28 Published:2015-08-28

摘要/Abstract

摘要：

目的拟从阴道菌群的微生态特征入手,旨在探讨阴道微生物群落结构与外阴阴道念珠菌病(Vulvovaginal Candidiasis,VVC)发病的潜在联系。方法 2013年1月~2014年12月,126名处于VVC急性发作且以往有RVVC史的非孕育龄妇女作为研究对象,另有120名正常育龄期体检女性作为对照组。测定阴道pH值,并采集阴道分泌物行革兰染色镜检,行Nugent评分。同时,通过阴道菌群密集度、菌群多样性、优势菌等指标对阴道微生态进行评价。结果患者组的阴道pH值(4.51±0.3 Vs 4.11±0.2,P<0.05)和Nugent评分(4.21±0.81 Vs 1.31±1.19,P<0.05)显著高于对照组。患者组乳酸杆菌密集度显著低于对照组,而阴道加特纳菌/普雷沃菌、革兰阳性球菌和其他细菌的密集度显著高于对照组(P<0.05)。同时,患者组菌群多样性显著高于正常组;且患者组乳酸杆菌优势比例显著低于对照组(55.56% Vs 95.00%,P<0.05),而阴道加特纳菌/普雷沃菌(23.02% Vs 1.67%,P<0.05)和革兰阳性球菌优势比例显著高于对照组(17.46% Vs 1.67%,P<0.05)。结论 RVVC患者阴道微生态特征与正常育龄妇女存在显著差异,生物屏障的削弱可能是VVC反复发作的风险因素。新型阴道乳酸菌制剂的研发和应用可能在重建阴道微生态,预防VVC复发方面获得突破。

关键词: 复发性外阴阴道念珠菌病(RVVC), 阴道微生态, 乳酸杆菌, 阴道加特纳菌/普雷沃菌

Abstract:

Objective To investigate the vaginal microecology features in women with recurrent vulvovaginal candidiasis (RVVC) and its etiological role.Methods From January 2013 to December 2014, 126 cases suffering with RVVC were studied, whereas 120 healthy reproductive-age women were enrolled as control.The secretions were examined by Gram stain grouped and Nugent scoring system, as well as the vaginal pH was determined simultaneously.In addition, vaginal bacteria and micro-ecology features (such as vaginal flora density, diverse and predominant population) were measured.Results The vaginal pH (4.51±0.3 Vs 4.11±0.2, P<0.05) and Nugent score (4.21±0.81 Vs 1.31±1.19, P<0.05) in RVVC group were significantly increased when compared with those in control group.The density of Lactobacillus was significantly decreased (P<0.05), whereas the density of Gardnerella/Prevotella and gram-positive cocci were significantly decreased in RVVC group (P<0.05).Additionally, the flora diverse in RVVC group was significantly raised with lower proportion of Lactobacillus-dominating community and high proportion of Gardnerella/Prevotella as well as gram-positive cocci-dominating community.Conclusion The significant alternations of vaginal bacterial community composition and structure were observed in RVVC women.Such compromising in vaginal biological barrier might relate to the risk to the recurrence of VVC, and future breakthrough might benefit from establishing new therapeutic targets and providing protective strategies for rebuilding vaginal bacterial community by developing novel probiotic Lactobacillus.

Key words: recurrent vulvovaginal candidiasis (RVVC), vaginal micro-ecology, Lactobacillus, Gardnerella/Prevotella

中图分类号:

R519.3

范娟, 沈健, 蒋建华, 刘延. 复发性外阴阴道念珠菌病的阴道微生态特征分析[J]. 中国真菌学杂志, 2015, 10(4): 210-215.

FAN Juan, SHEN Jian, JIANG Jian-hua, LIU Yan. The vaginal bacteria and micro-ecology features in women with recurrent vulvovaginal candidiasis[J]. Chinese Journal of Mycology, 2015, 10(4): 210-215.

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