乳杆菌活菌胶囊治疗妊娠期细菌性阴道病的临床观察

目的 调查妊娠期细菌性阴道病（BV）的发病情况，观察乳杆菌活菌胶囊治疗细菌性阴道病的疗效。方法对不同孕周的926名孕妇进行BV筛查，确定妊娠期细菌性阴道病的发病率。取BV患者164例，乳杆菌活菌胶囊治疗82例，孚舒达栓治疗82例，用药10d，停药1w后复查。结果妊娠期BV的检出率为17．71％。乳杆菌活菌胶囊治疗BV有效率89．02％，孚舒达栓治疗BV有效率87．80％，二者差异无显著性（P〉0．5）。结论妊娠期BV有较高的发病率，乳杆菌活菌胶囊是治疗BV的安全有效药物。     

乳杆菌活菌胶囊治疗复发性细菌性阴道病的临床观察

目的观察乳杆菌活菌胶囊治疗复发性细菌性阴道病的疗效。方法取复发性细菌性阴道病患者120例,治疗组给予乳杆菌活菌胶囊治疗60例,对照组给予甲硝唑治疗60例,用药10d,停药后5、30、90d复查。结果治疗组再次复发率明显低于对照组（P〈0.05）。结论乳杆菌活菌胶囊是治疗复发性细菌性阴道病的安全有效药物。此法疗效好,复发率低。     

乳杆菌活菌胶囊治疗妊娠期细菌性阴道病及对妊娠结局的影响

目的调查妊娠期细菌性阴道病（BV）的发病情况，观察乳杆菌活菌胶囊治疗细菌性阴道病的疗效及对妊娠结局的影响。方法对不同孕周的926名孕妇进行BV筛查，确定妊娠期细菌性阴道病的发病率。乳杆菌活菌胶囊治疗82例．用药10d，停药1w后复查。结果妊娠期BV的检出率为17．71％。乳杆菌活菌胶囊治疗BV有效率89．02％，胎膜早破、早产、胎儿窘迫和新生儿窒息的发生，治疗组均低于未治疗组，差异有显著意义（P〈0．05）。结论妊娠期乳杆菌活菌胶囊治疗BV可降低胎膜早破、早产、胎儿窘迫和新生儿窒息的发生，乳杆菌活菌胶囊是治疗BV的安全有效药物。我们认为，为了提高产科质量，有必要对妊娠妇女进行BV的系统筛查和治疗。     

细菌性阴道病致胎膜早破的临床分析

目的 探讨细菌性阴道病(bacterial vaginosis,BV)对晚期妊娠胎膜早破的关系。方法 随机抽取2000年1月～2001年12月在我院产检的孕28w的无妊娠合并症及高危因素的初产孕妇312例作为对照组,再将同期间的孕28w时确诊有BV而无其他任何合并症及高危因素的初产孕妇162例作为病例组,追踪病例至分娩。结果 发现两者胎膜早破的发生率分别为6.09％和18.34％(P<0.01);发生时的平均孕周分别为38.9±2.7和36.8±3.4(P<0.05)。结论 BV可以增加胎膜早破的发生率和提早发生的时间,因此做好孕前及孕期的卫生健康指导,并常规筛查以及积极冶疗BV对优生优育有重要作用。     

细菌性阴道病与胎膜早破的关系

目的了解细菌性阴道病与胎膜早破的关系。方法356名孕妇分为正常孕妇组295例、胎膜早破组61例,对阴道分泌物进行细菌性阴道病(BV)的检测,同时做细菌培养了解是否合并其他微生物感染,并追踪观察妊娠结局。结果胎膜早破组BV发生率为57.38%,明显高于正常孕妇组(9.15%),差异有显著性(P<0.05)。结论妊娠合并BV与胎膜早破明显相关,有必要对妊娠合并BV孕妇进行治疗。     

早孕期细菌性阴道病的研究

目的了解早孕期妇女合并细菌性阴道病(BV)的发病情况及对早期妊娠的不良影响.方法对1056例在我院门诊就医的早孕妇女进行阴道分泌物BV的筛查.结果检出BV130例(12.31%),霉菌性阴道炎76例(7.20%),滴虫性阴道炎51例(4.83%),BV合并霉菌性阴道炎、滴虫性阴道炎分别是15、7例(占11.54%、5.38%).先兆流产18例,14例感染BV,胚胎停育11例,9例BV阳性.结论早孕合并BV感染明显高于霉菌性阴道炎和滴虫性阴道炎.早孕期BV是导致先兆流产的重要相关因素.有必要在早孕期行BV的筛查和治疗.     

细菌性阴道病感染与先兆流产关系的研究

目的确探讨细菌性阴道病感染情况与先兆流产的关系.方法分别对128例先兆流产孕妇和117例正常孕妇进行细菌性阴道病检查鉴定.结果先兆流产孕妇细菌性阴道病感染率为32.81%,正常孕妇细菌性阴道病感染率为23.08%,两组相比,有显著性差异(P＜0.01).结论为提高妊娠成功率,预防细菌性阴道病的发生,及时诊断和治疗细菌性阴道病十分必要.     

克林霉素治疗妊娠合并细菌性阴道病的疗效观察

目的：探讨克林霉素阴道凝胶治疗无高危因素的妊娠合并细菌性阴道病对妊娠结局的影响。方法随机选取我院门诊无高危因素的妊娠期孕妇,使用格兰染色Nugent评分法诊断细菌性阴道病,妊娠合并细菌性阴道病的孕妇按照随机原则分为克林霉素治疗组及无特殊治疗的对照组,随访至妊娠终止,观察比较两组孕妇发生早产、胎膜早破、低体重儿及新生儿入重症监护室的情况。结果克林霉素组早产(4.3%VS11.3%)、胎膜早破(13.7%VS22.6%)的发生率较对照组低,差异具有统计学意义(<0.05),低体重儿、新生儿入重症监护室的发生机会较对照组低,但差异无统计学意义。结论克林霉素能够有效治疗妊娠期细菌性阴道病,可降低无高危因素的妊娠期细菌性阴道病引起的早产、胎膜早破的风险,但对低体重儿及新生儿入重症监护室的风险无明显影响。     

细菌性阴道病对妊娠结局的影响

目的：确定细菌性阴道病（ＢＶ）在妊娠妇女中的发病情况及对母婴的不良影响。方法：以四项临床诊断指标中符合３项并阴道涂片革兰染色细菌评分≥７分作为ＢＶ的诊断标准,对４０６名初次产检的孕妇进行ＢＶ的筛查,追踪其中３４名单纯合并ＢＶ者和２５２名无ＢＶ者的妊娠结局。结果：１．妊娠期ＢＶ的发病率为１１．８２％,其中中孕早期的患病率为９．７２％,孕晚期患病率为１４．２８％。２．有ＢＶ组的早产、组织学绒毛膜羊膜炎     

细菌性阴道病对妊娠的影响

目的探讨妊娠合并细菌性阴道病(BV)对不良妊娠结局的影响。方法对孕8～28w的412例孕妇进行细菌性阴道病检查,排除其他病原体感染,并对妊娠合并细菌性阴道病与妊娠及分娩并发症以及围生期并发症的关系。结果 412例孕妇中,检出BV61例,检出率为14.81%,妊娠合并细菌性阴道病的不良妊娠结局,其流产、胎膜早破、早产的发生率分别为13.11%;9.84%;6.56%。不良妊娠结局发生率为29.51%。结论妊娠合并细菌性阴道病增加了不良妊娠结局的发生。加强孕前、孕期细菌性阴道病的筛查,早期诊断,早期治疗是十分必要的。     

灭滴灵阴道用药对细菌性阴道病晚孕妇女不良妊娠结局的预防效果

目的：探讨灭滴灵治疗细菌性阴道病对不良妊娠结局是否有改善作用。方法：在产科门诊对用阴道分泌物涂片革兰氏染色Ｎｕｇｅｎｔ诊断标准孕２８－３２周妇女进行细菌性阴道病筛查，对检出的患者随机分为二组；观察组５２例，未给予治疗；治疗组５０例，采用灭滴灵阴道用药治疗，必要时再次治疗。     

Probiotics for the treatment of women with bacterial vaginosis

This review considers whether probiotics are effective agents for the treatment and/or prevention of bacterial vaginosis (BV). There seems to be an association between the absence of, or low concentrations of, vaginal lactobacilli and the development of BV. Many studies have suggested that the presence of H2O2-producing vaginal lactobacilli may protect against BV, although some studies do not support this hypothesis. In-vitro studies have suggested that certain specific strains of lactobacilli are able to inhibit the adherence of Gardnerella vaginalis to the vaginal epithelium and/or produce H2O2, lactic acid and/or bacteriocins, which inhibit the growth of bacteria causing BV. Clinical trials showed that intra-vaginal administration of Lactobacillus acidophilus for 6-12 days, or oral administration of L. acidophilus or Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14 for 2 months, resulted in the cure of BV (defined as a 0-1 positive score according to Amsel's criteria), and/or reduced the recurrences of BV, and/or caused an increase in vaginal lactobacilli and restoration of a normal vaginal microbiota, significantly more frequently than did a placebo, acetic acid or no treatment. However, several trials have found no significant difference in the cure rate of BV and in the number of vaginal lactobacilli after intra-vaginal instillation of lactobacilli when compared with the effect of a placebo or oestrogen. Thus, although the available results concerning the effectiveness of the administration of lactobacilli for the treatment of BV are mostly positive, it cannot yet be concluded definitively that probiotics are useful for this purpose.     

妊娠合并细菌性阴道病对妊娠结局影响的临床研究

目的探讨妊娠期细菌性阴道病对胎膜早破、早产、产褥感染和新生儿感染等不良妊娠结局的关系。方法在定期产检的孕妇410例进行细菌性阴道病的筛查,进行孕期及围产期随访,分析妊娠期细菌性阴道病与分娩方式、胎膜早破、早产、产褥感染和新生儿感染等的相关性。结果410例孕妇中检出妊娠合并细菌性阴道病52例,检出率为12.68%,妊娠合并细菌性阴道病者的胎膜早破、早产、产褥感染和新生儿感染发病率均明显高于未感染的孕妇。结论妊娠合并细菌性阴道病明显增加孕妇胎膜早破、早产、产褥感染和新生儿感染的机会。加强产前筛查,早期诊断,早期治疗是十分必要的。     

Effectiveness of Lactobacillus-containing vaginal tablets in the treatment of symptomatic bacterial vaginosis

The purpose of this study was to determine the effectiveness of Lactobacillus -containing vaginal tablets in the treatment of bacterial vaginosis (BV) and in the restoration of a healthy vaginal flora. Thirty-nine women with BV were enrolled in a double-blind, placebo-controlled clinical trial. Patients received either one Lactobacillus -containing tablet or placebo daily for 7 days. Clinical criteria, vaginal Gram stain scores and symptoms were compared with those at the initial visit and those at completion of therapy and 2 weeks later. After completion of therapy, all of the patients in the Lactobacillus -treated group ( n  = 18) were free of BV, showing a normal (83%) or intermediate (17%) vaginal flora, as compared with only two patients free of BV with intermediate flora (12%) from among the 16 placebo-treated women (p   <0.001). Two weeks after completion of therapy, treatment was successful (score <7) in 61% of Lactobacillus -treated patients as compared with 19% of those in the placebo group (p   <0.05). In the treatment group, the total number of symptomatic patients and the intensity of their symptoms, in particular vaginal malodour, were significantly reduced at both follow-up visits. The data indicate that intravaginal administration of exogenous selected strains of lactobacilli can restore a normal vaginal microbiota and be used in treating bacterial vaginosis.     

Trimethylamine content in vaginal secretion and its relation to bacterial vaginosis

The presence of a fishy odor emanating from women who present with a malodorous vaginal discharge is well known. The odor is due to bacterial reduction of trimethylamine oxide to trimethylamine (TMA) in vaginal secretion. The release of TMA from specimens of vaginal fluid following the addition of alkali is often used in making a clinical diagnosis of bacterial vaginosis (BV). We now report a sensitive gas chromatographic method for analysis and quantification of TMA in vaginal fluid in which weighed samples were used. In addition, a proper diagnosis of BV was obtained using Gram-stained smears of the vaginal fluid according to the method of Nugent et al. (R. P. Nugent et al., J Clin Microbiol 1991;29:297-301). We also diagnosed BV according to Hallén et al. (A. Hallén et al. Genitourin Med 1987;63:386-9). TMA was present in all women with a Nugent score between 7 and 10 and in almost all women diagnosed with BV according to the method of Hallén et al. TMA was not found or was only found in very low concentrations in vaginal fluid from women with Nugent scores of 0 to 3. TMA was also found in four women with a negative sniff test. It seems that high levels of TMA in samples of vaginal fluid are typical for BV regardless of the scoring method used for diagnosis. However, low levels of TMA, <5 microg/g vaginal fluid, do not always correlate with BV.     

Biotypes and virulence factors of Gardnerella vaginalis isolated from cases of bacterial vaginosis

The present study was conducted to correlate the biotypes of Gardnerella vaginalis strains isolated from cases of bacterial vaginosis and their virulence factors. Thirty-two strains of G. vaginalis isolated from cases of bacterial vaginosis were biotyped. Adherence to vaginal epithelial cells, biofilm production, surface hydrophobicity, phospholipase C and protease activity were tested on these isolates. Biotype 1 was the most prevalent (8; 25%), followed by biotype 2 (7; 21.9%) and biotypes 5 and 8 (5; 15.6%). We did not find any statistical correlation between G. vaginalis biotypes and its virulence factors. Virulence factors expressed by G. vaginalis were not associated with a single biotype.     

Use of DNA hybridization test for diagnosing bacterial vaginosis in women with symptoms suggestive of infection

The purpose of this study was to evaluate a DNA hybridization test (Affirm VPIII) as an alternative to Gram stain for the rapid diagnosis of bacterial vaginosis in women with clinical signs of vaginal infection. Vaginal specimens were collected from 321 symptomatic women, and analyzed for bacterial vaginosis by both Gram stain using Nugent criteria and DNA hybridization test. Sensitivity, specificity, positive predictive value, and negative predictive value of the DNA hybridization test were determined using the Gram staining as the standard for diagnosis of bacterial vaginosis. Of the 321 patients, 115 (35.8%) were Gram positive for bacterial vaginosis and 126 (39.2%) were negative. 80 patients (25.0%) demonstrated intermediate Gram staining that was also considered negative. The Affirm system detected G. vaginalis in 107 (93.0%) of 115 vaginal specimens positive for bacterial vaginosis diagnosed by Gram stain. Compared to the Gram stain, DNA hybridization test had a sensitivity of 87.7% and a specificity of 96.0%. Positive and negative predictive values of the DNA hybridization test were 93.0% and 92.7%, respectively. In conclusion, Affirm VPIII hybridization test correlated well with Gram stain and may be used as a rapid diagnostic tool to exclude bacterial vaginosis in women with genital complaints.     

An international study of the interobserver variation between interpretations of vaginal smear criteria of bacterial vaginosis

An international workshop on vaginal smear-based diagnosis of bacterial vaginosis was organized where 13 investigators scoring 258 slides with smears from vaginal fluid. Interobserver reproducibility of interpretations of Nugent scores, Hay/Ison scores and wet smear scores for the diagnosis of bacterial vaginosis was shown to be high. Detailed analysis of individual scoring results however indicated that basic standards of quality control to ensure robust individual readings of slides must be adhered to.