外阴阴道念珠菌病阴道乳酸杆菌的分布及作用

目的 通过对外阴阴道念珠菌病（vulvovaginal candidiasis，VVC）患者与正常妇女阴道乳酸杆菌优势菌种和产H2O2能力的比较，初步探讨乳酸杆菌在VVC发病中的作用。方法 以66例VVC患者为实验组，50例正常妇女为对照组。1．将阴道分泌物接种在MRS乳酸杆菌琼脂培养基上，在CO2环境下培养，采用微量生化试验鉴定乳酸杆菌；2．将乳酸杆菌接种在H2O2鉴定培养基上，根据显色鉴定是否产H2O2。结果1．两组在乳酸杆菌的分布上无差别（P〉0．05），均以嗜酸乳酸杆菌、詹氏乳酸杆菌和卷曲乳酸杆菌为优势菌种；2．对照组H202阳性乳酸杆菌的分离率明显高于实验组，分别为23例（46％）和6例（9．09％），有显著性差异（P〈0．01）；3．两组内三种优势乳酸杆菌产酸能力相似（P〉0．05），但两组间相比，VvC组嗜酸乳酸杆菌和卷曲乳酸杆菌产H202能力较对照组下降（P〈0．05）。结论 1．VVC患者与正常妇女阴道内乳酸杆菌菌种分布相似；患VVC后阴道嗜酸乳酸杆菌和卷曲乳酸杆菌产酸能力下降；2．VVC的发生与H2O2阳性乳酸杆菌的数量有关。

Distribution and effect of Lactobacilli in vulvovaginal candidiasis

Objective To explore the effect of Lactobacilli in vulvovaginal candidiasis(VVC)by comparing distribution of Lactobacilli species and the ability of generating H2O2 between VVC patients and healthy women.Methods Sixty six patients who were diagnosed as having VVC fell into study group,while 50 healthy women fell into control group.1).Vaginal fluid was inoculated on MRS agar medium,and cultivated under CO2,and Lactobacilli species were identified by using biochemical method.2).Lactobacilli were inoculated on H2O2 identification medium to identify its H2O2-generation.Results 1).The predominant species of the two groups were L.acidophilus,L.crispatus and L.jensenii,but no significant difference in distribution of Lactobacilli was seen between them(P>0.05).2).There was significant difference in the isolation rates of H2O2-generating Lactobacilli between the two groups(P<0.01).3).Three predominant Lactobacilli species in the two groups had similar ability of generating H2O2(P>0.05),but the ability of generating H2O2 of L.acidophilus and L.crispatus in the study group was lower than in the control group(P<0.05).Conclusions 1)VVC patients and healthy women have similar predominant Lactobacilli species-L.acidophilus,L.crispatus and L.jensenii.L.acidophilus and L.crispatus have lower ability of generating H2O2 in VVC patients.2)The development of VVC is associated with amounts of H2O2-generating Lactobacilli.