白带涂片革兰氏染色法对细菌性阴道病诊断的探讨

目的:探讨对细菌性阴道病检测方法以降低漏诊率。方法:2009年7月至12月间随意抽查200例患者,白带涂片采用"金标准"Amsel、s法同时结合本院实验室建立的革兰氏染色法进行检测。结果:200例受检者Amsel、s标准检测出患者40例、革兰氏染色查出线索细胞31例,分别占20%和15.5%。计算乳酸杆菌和加德纳菌的数量变化阳性56例、临界状态10例,分别占28.0%和5.0%;乳酸杆菌和加德纳菌的数量变化以Amsel、s法为标准,革兰氏染色计算两种细菌的数量变化诊断细菌性阴道病(BV)的敏感性为92.5%,特异性88.1%。阳性检出率明显高于Amsel、s标准法(χ2=10.2,P0.005)。结论:目前使用传统的Amsel、s标准法因某些因素干扰而致漏诊,我院采用革兰氏染色计算乳酸杆菌和加德纳菌的数量变化可降低诊断细菌性阴道病的漏诊率。

Gram's staining methods for Leucorrhea smear in the diagnosis of bacterial vaginosis

Objectives：To explore the diagnostic method for bacterial vaginosis to reduce the rate of missed diagnosis. Methods： From July to December 2009, Leucorrhea smear of 200 randomly selected patients were tested with Gram’s staining method and Amsel’s method. Results： Among 200 tested patients, Amsel’s detected 40 cases （20%） and Gram’s staining detected 31 cases （15.5%）. The change of the number of Lactobacillus and gardnerella indicated 56 positive cases, 10 borderline cases, accounting for 20% and 15.5% respectively. Taken Amsel, s methods as the standard in assessing the change of the number of Lactobacillus and gardnerella, Gram’s staining produced 92.5% sensitivity and 88.1% specificity in counting the change of the number of two bacteria. Gram’s staining diagnostic rate is significantly higher than Amsel （χ^2=10.2,P〈0.005 ）. Conclusion： Missed diagnosis could be introduced by traditional Amsel, s standard method due to the influence of other factors. The application of Gram’s staining in the counting of the number of Lactobacillus and gardnerella can greatly reduce the rate of missed diagnosis of bacterial vaginosis.