阴道和宫颈涂片镜检诊断细菌性阴道病

确定阴道涂片和宫颈涂片检查诊断细菌性阴道病的敏感性和特异性。方法对１９６例（包括９４例细菌性阴道病）育龄期未孕患者进行阴道分泌物涂片及宫颈涂片检查，显微镜下观察计数细菌形态及数量。结果以临床诊断为标准，阴道涂片和宫颈涂片诊断细菌性阴道病的敏感性和特异性分别为９４．７％（８９／９４）、９８．０％（１００／１０２）和８５．１％（８０／９４）、９５．１％（９７／１０２）。细菌性阴道病的涂片特征为阴道加德纳菌、类杆菌形态及革兰变异弯曲弧菌形态的小细菌占优势，并且乳酸杆菌形态细菌缺乏。结论应用阴道涂片及宫颈涂片检查诊断细菌性阴道病，使筛查和及时治疗细菌性阴道病成为可能。     

细菌性阴道病与宫颈上皮内瘤样病变

细菌性阴道病与宫颈上皮内瘤样病变［英］斯湛地纳维亚妇产科学报１９９４，７３：５８６～５８８宫颈上皮内瘤样病变（ＣＩＮ）和宫颈癌是妇女患病率与死亡率的主要原因。过去证实这种类型的癌仅发生于性活动频繁的妇女，这一发现导致了对下列因素的关注：如婚姻状况，初...     

宫颈涂片在诊断细菌性阴道病中的价值

目的探讨宫颈涂片在细菌性阴道病(BV)诊断中的价值。方法对289例(其中包括141例细菌性阴道病)育龄期妇女进行阴道分泌物涂片和宫颈涂片检查,同期分别检测线索细胞。结果宫颈涂片和阴道涂片诊断细菌性阴道病的敏感性、特异性、阳性预测值、阴性预测值分别为:93.62%和97.87%、95.27%和97.30%、94.96%和97.89%、94.00%和97.96%。两种检测方法之间的差异无统计学意义(P>0.05)。结论宫颈涂片与阴道涂片在BV的诊断方面具有良好的一致性,具有临床诊断应用价值。     

细菌性阴道病及人类乳头状瘤病毒感染与宫颈疾病关系的研究

目的 探讨细菌性阴道病(bacterial vaginosis,BV)及人类乳头状瘤病毒(human papilloma vi-rus,HPV)感染与宫颈疾病的关系.方法 选取2010年4月～2020年4月本院妇科门诊患者1418例,进行BV、HPV检测,并行液基细胞学检查(TCT)及阴道镜宫颈活检病理检查.结果 14...     

细菌性阴道病检测试剂诊断细菌性阴道病

目的:探讨应用细菌性阴道病(BV)检测试剂检测BV的临床应用价值。方法:取200例疑为BV的标本,同时用BV快测试剂和Amsel标准检测BV。结果:与传统的Amsel标准相比,BV检测试剂法诊断BV的敏感性为92.5%,特异性为88.1%,阳性预测值为66.1%,阴性预测值为97.9%。结论:BV检测试剂法是可靠、快速、简便的诊断BV的方法,值得推广。     

妊娠期细菌性阴道病

细菌性阴道病(BV)是一种常见的阴道感染性疾病，是引起异常阴道分泌物和其他症状的主要原因。最近，人们逐渐认识到细菌性阴道病与许多不良妊娠结局直接相关。现就这方面的研究综述如下。     

细菌性阴道病与阴道清洁度的关系

目的探讨细菌性阴道病（BV）的发病情况与阴道清洁度的关系。方法采用多胺法对1961例在皮肤病性病门诊就诊的妇女阴道分泌物进行BV及阴道清洁度检测。结果BV总阳性率为15．2％,其中阴道清洁度Ⅲ-Ⅳ度者BV阳性率为22．5％,明显高于阴道清洁度为Ⅰ～Ⅱ度者（7．7％）,差异有统计学意义（P〈0．01）。结论细菌性阴道病与阴道清洁度有密切关系,我们建议应把BV检测列入皮肤病性病门诊的常规检测项目。     

阴道清洁度与细菌性阴道病相关性分析

目的了解细菌性阴道病的发生率及其与阴道清洁度的关系。方法分别采用湿涂片法对1175例患者的阴道分泌物进行阴道清洁度和细菌性阴道病(bacterial vaginosis,BV)检查。结果 BV阳性例数150例,其中清洁度Ⅰ～Ⅱ者17例,Ⅲ～Ⅳ133例;BV总阳性率为10.8%,其中阴道清洁度Ⅰ～Ⅱ者BV阳性率为3.2%,Ⅲ～Ⅳ度者为20.5%。Ⅲ、Ⅳ度BV阳性率明显高于清洁度为Ⅰ、Ⅱ者,差异有统计学意义(P<0.005)。结论 BV跟清洁度有密切关系,应把BV纳入妇科普查项目,尤其是清洁度Ⅲ～Ⅳ度的患者。     

细菌性阴道病的诊断与治疗

细菌性阴道病是阴道加德纳细菌与某些厌氧菌混合感染引起的.曾命名为嗜血杆菌阴道炎、棒状杆菌阴道炎、非特异性阴道炎等,是妇女中常见的感染之一.本病系阴道内乳酸杆菌减少而其他细菌大量繁殖所致,除阴道加德纳氏菌外,还有其他厌氧菌,且临床上以阴道分泌物增多,局部无明显炎症反应,分泌物中自细胞少为特点,故称为细菌性阴道病.临床表现为阴道排液增多,有恶臭味或鱼腥味,可伴有轻度外阴瘙痒或烧灼感.白带呈灰白色,均匀一致的稀薄状,有时可有泡沫.窥器检查可见白带增多,分泌物容易从阴道壁擦掉,阴道粘膜无充血、斑点等炎症改变.     

细菌性阴道病的规范化诊疗进展

细菌性阴道病（BV）是妇女常见阴道感染性疾病,为阴道内正常菌群失调导致的非炎症性表现的症候群。BV病因复杂,单纯使用抗生素虽可暂缓症状,迅速复发通常无法避免,会出现治疗失败或并发混合性感染。本综述对BV的病原菌检测和临床诊断标准进行了阐述,并对临床常用的初次治疗及复发性BV的治疗方案进行了系统的总结,同时在病理生理学及微生物学基础上,结合宿主阴道内微环境平衡的理念,为BV治疗提供了新的视角。     

Human papilloma virus 16/18 genotypes in patients with squamous cell carcinoma of cervix in northeast Iran

Background:

A relation has been established between infection with high-risk types of human papilloma virus (HPV) and development of cervical cancer. To estimate the risk of HPV infection for cervical malignancies, we conducted a case-control study in northeast Iran.

Materials and Methods:

This study was carried out on 123 paraffin embedded blocks with exact diagnosis of squamous cell carcinoma (SCC). A total of 100 cervical tissue specimens with normal histopathology product of hysterectomy were also used as control. Both groups were tested for the presence of HPV DNA and HPV 16/18 subtypes using PCR assay.

Results:

Large non-keratinising subtype of cervical carcinoma was the most frequent one (62.6%), followed by keratinising and small cell subtypes (27% and 10%, respectively). Overall prevalence of HPV infection in SCC of cervix was 34.2% (42 out of 123 cases). HPV 16 was the most common type in this group (21 cases, 17.1%), followed by HPV 18 (16 cases, 13%) and other subtypes (5 cases, 4.1%). In this study, overall prevalence of HPV infection in control group was 12% (including 3% HPV 16; 5% HPV 18 and 4% other subtypes).

Conclusion:

Although association of HPV 16/18 and SCC of cervix was relatively higher than control group, compared with the previous study, the association between cervical SCC and HPV infection was significantly lower in our study; and possibly, the other risk factors play a major role in carcinogenesis of cervical carcinoma in this region.     

唾液酸酶法及多胺法在诊断细菌性阴道病中的应用

目的探讨唾液酸酶法及多胺法在诊断细菌性阴道病中的价值.方法以Amsel诊断标准评价唾液酸酶法及多胺法的灵敏度和特异性.结果唾液酸酶法灵敏度和特异性分别为89.2%与97.8%,多胺法分别为92.3%与86.7%;Amsel法中胺试验阳性率明显低于多胺法的阳性率(P<0.005);多胺法替代Amsel法中胺试验时,Amsel法的特异性和诊断效率分别为94.8%和96.0%.结论唾液酸酶法检测快速、简便、可靠且便于质量控制,适合作为临床诊断的有效指标.多胺法作为单独的诊断方法其特异性略低,以其替代Amsel诊断标准中的胺试验有助于提高Amsel法的特异性和临床诊断效率.     

线索细胞分级法在细菌性阴道病诊断中的应用

目的：探索线索细胞分级法在细菌性阴道病（BV）诊断中的应用价值。方法：用革兰染色涂片计算线索细胞在全部上皮细胞中所占百分比进行分级。结果：BV病人与非BV病人在线索细胞（＋）时,无显著性差异（P＞0．05）,在线索细胞为（＋＋）－（＋＋＋＋）时,差异有极显著性（P＜0．001）。当线索细胞达到（＋＋）以上时,诊断的敏感度为1005,特异性为98．8％。结论：线索细胞分级可作为BV诊断的一个半定量指标。     

细菌性阴道病的发病率及治疗的探讨

目的了解细菌性阴道病在外阴、阴道感染中所占的比例,及对治疗方法的探讨。方法2004年10月~2005年2月,在我院妇科门诊就诊的1280例患者进行白带检查,按BV的诊断标准,给BV患者口服甲硝唑0．2g,tid,连用3d。曼舒林1片阴道上药,每日1次,连用4d。1周和2周后各复查1次。结果BV患者妇科门诊的患病率为11．02％。外阴阴道感染患者中的28．78％是BV患者,其中20％以腹痛、不孕症就诊。治愈率100％。结论BV患者在妇科门诊患者中占有较大的比例。应常规检查、甲硝唑联合曼舒林治疗BV,疗程短,方法简便,治愈率高。     

Comparison of main lactobacillus species between healthy women and women with bacterial vaginosis

Background The normal microbial flora of the vagina plays an important role in preventing genital and urinary tract infections in women. Thus an accurate understanding of the composition and ecology of the ecosystem is important to understanding the etiology of these diseases. This study aimed to compare the characteristics of main lactobacillus species between healthy women and women with bacterial vaginosis （BV） by quantitative culture and PCR methods. Main lactobacillus species include L. crispatus , L. gasseri, L. jensenii and L. iners.
Methods A total of 150 Women attending Gynecology Outpatient Clinic of Beijing Friendship Hospital, were diagnosed as having BV because three or more of the following criteria were met （standard of Amsel＇s composite criteria）： homogeneous discharge, elevated vaginal pH （pH 〉4.5）, production of amines, and presence of ＂clue＂ cells. Those with less than three of the criteria were considered as healthy. Simultaneously, smears were made of vaginal fluid and Gram stained, then were assessed qualitatively as normal （grade Ⅰ）, intermediate （grade Ⅱ）, or consistent with BV （grade Ⅲ）. Gardnerella vaginalis were identified by using Vitek 2 Compact and PCR methods. Lactobacillus species were identified by PCR methods. Gardnerella vaginalis and lactobacilli colony counts were determined by calculating the most number of colonies of each species in the appropriate plates （colonies between 10 and 300）, corrected by the dilution of the sample in the plates, and multiplied by 10 （to account for plating 100 μl）, in order to get colony forming units per milliliter of vaginal secretion.
Results BV was diagnosed in 31% （46/150） patients using the composite criteria, the remainder being regarded as healthy. The majority of patients with BV had a smear assessed as grade Ⅲ （91%, 42/46） and minority of them had a smear assessed as grade Ⅱ（9%, 4/46）. The majority of healthy women had a smear assessed as grade Ⅰ （64%, 67/104）. Smears assessed as grade Ⅱwere found （36%, 37/104） among patients diagnosed as healthy, with less than three of the composite criteria. L. crispatus was cultured from 94% of healthy women and 83% of women with BV, with the former colonies count average value of 106 and the latter of 103. L. gasseri, L. iners, and L. jensenfi were cultured from 85%, 68% and 43% of healthy women; and 28%, 89% and 44% of BV women, respectively.
Conclusions The quantities of four lactobacillus species except L. jensenii had a significant difference between healthy women and women with BV. Our results provide support for the negative association between L. iners and L. gasseri. Although L. crispatus were existent both in healthy and BV positive women＇s vagina, the numbers of L. crispatus were significantly different for the dominant number in healthy women. Smears of vaginal fluid and Gram stain play an important guiding role in bacteria culture.     

宫颈癌与HPV16，18的关系研究

目的：结合临床和流行病学探讨HPV16,18与宫颈癌的关系。方法将178例宫颈癌及宫颈上皮内瘤变（CIN）标本采用HE染色及免疫组化SP法,标记宫颈上皮病变中的HPV16,18,并取同期10例正常宫颈组织作对照。结果138例宫颈癌标本的HPV16,18平均阳性率为70.3%,其中〈55岁年龄组宫颈癌102例, HPV阳性率为90.2%,≥55岁年龄组36例,阳性率为13.9%,组间阳性率比较有显著差异（P〈0.01）。HPV16（＋）组共52例,其中宫颈鳞癌47例,腺癌5例;HPV18（＋）45例,宫颈鳞癌11例,腺癌34例,组间阳性率比较有显著差异（P〈0.01）。结论 HPV的感染与宫颈癌相关,HPV16型感染多见于宫颈鳞癌,而18型多见于宫颈腺癌。     

应用ARDRA技术对细菌性阴道病的微生态分析

目的 了解细菌性阴道病(BV)患者阴道细菌种群微生态变化.方法 采用ARDRA方法对3例BV患者及1例健康妇女阴道分泌物的细菌16S rDNA进行分析.结果 3例BV患者分别检测到37、36和31个OTUS,而正常妇女中仅检测到16个;健康妇女阴道的优势菌群为乳酸杆菌,而BV患者中的优势菌群包括纤毛菌属、普氏菌属、埃氏巨型球菌属等.3例BV患者所检测的11个优势克隆子中,仅2个为已纯培养的细菌,其余9个均为未纯培养细菌.结论 细菌性阴道病患者与健康妇女的微生态存在明显差异,DNA限制性分析技术是对阴道菌群微生态进行快速分析的有力工具,可以鉴定出常规培养方法不能鉴定的潜在致病菌.     

检测细菌性阴道病干化学法的建立及评价

利用肉眼观察反应产物颜色的变化探讨研发试剂与酶标准品的最佳反应条件,在pH值6.2,37℃,15 min,MSTT为10μg时,研发干片与酶标准品达到最佳反应。临床实验中,将研发试剂、细菌性阴道病(BV)BLUE、国产试剂盒分别对临床标本进行对比检测,研发试剂与BV BLUE对BV的检测效果差异无统计学意义,符合率为97%。而国产A试剂盒与BV BLUE对BV的检测效果差异有统计学意义(P<0.01,χ2=0.390,r=0.42),符合率仅为67%。     

线索细胞法检查对细菌性阴道病的诊断价值

目的探讨线索细胞法检查对细菌性阴道病（BV）的诊断价值。方法对350例疑似BV患者的阴道分泌物分别用Amsel法、线索细胞法、Nugent评分法进行检测,以Amsel法的检测结果为标准,其他二种方法与之进行比较。结果Amsel法检出BV阳性217例,线索细胞法阳性225例,其中真阳性203例,Nugent评分阳性227例,其中真阳性207例。线索细胞法诊断BV的敏感度94．4％,特异度83．7％,诊断效率90．3％;Nugent评分敏感度95．8％,特异度85．1％,诊断效率91．7％。二种方法与Amsel法比较,以上指标差异均无统计学意义（均P〉0．05）。结论以线索细胞法作为诊断BV的标准,具有操作简便快速、结果准确、易于规范的特点,可作为阴道分泌物常规检查项目在临床开展应用。     

HPV18型与早期子宫颈腺癌患者预后的相关性

目的：探讨人乳头状瘤病毒(HPV)18型与早期子宫颈腺癌患者预后的相关性。方法选取2000年1月至2011年1月琼海市人民医院收治的110例子宫颈腺癌患者作为研究对象,采用PCR法进行HPV基因型检测,比较HPV18型感染与患者预后的关系。结果110例宫颈腺癌患者中HPV 18型阳性者66例,占60.00%。HPV 18型阳性者的淋巴结转移率(27.27%)、脉管瘤栓率(24.24%)明显高于阴性者(6.82%,4.85%,P<0.05)。HPV 18型阳性患者与阴性患者的5年无瘤生存率(86.36%vs 86.36%)、5年总生存率(87.88%vs 90.91%)、无瘤生存时间[(63.54±10.54)个月vs (65.01±12.41)个月]、总生存时间[(73.87±12.66)个月vs (75.11±13.68)个月]比较差异均无统计学意义(P>0.05)。结论 HPV18型感染与早期子宫颈腺癌患者的癌细胞转移有关,但其与患者的总生存时间、无瘤生存时间无明显相关性。