无症状及复发性细菌性阴道病的诊治

细菌性阴道病(bacterial vaginosis,BV)是阴道内厌氧菌混合感染,由正常菌群失调引起,是育龄期女性最常见的下生殖道感染性疾病[1-2]. 现如今阴道微生态的诊断评价体系已相对完善,国内外均有针对BV诊治的相关指南以指导临床治疗,但是对于特殊状态下BV的处理,如无症状性BV及复发性BV,临床实际工作中经...     

感染性阴道疾病3种病原体单克隆抗体的制备

目的研发感染性阴道疾病(细菌性阴道炎、滴虫性阴道炎和霉菌性阴道炎)的特异性单克隆抗体。方法分析感染性阴道疾病病原体的基因谱,扩增特异蛋白的基因序列,基因工程重组抗原AP33,免疫Balb/c小鼠,运用杂交瘤技术得到特异性单克隆抗体;采用间接酶联免疫吸附试验(ELISA)进行抗血清效价测定及抗体的亚类及轻链型鉴定;采用BCA法、聚丙烯酰胺凝胶电泳(SDS-PAGE)法分析纯品抗体的蛋白浓度、纯度和相对分子质量。结果杂交瘤细胞株产生的单克隆抗体纯度均达到了90%以上,抗体浓度2.41～5.68mg/mL,抗体效价在1∶105～1∶107之间;抗体类别均为IgG1,κ型。结论本研究获得了3种感染性阴道疾病纯度高、特异性强的单克隆抗体,将为药理学、诊断学及相关学科提供研究材料,具有广阔的市场前景和巨大的经济效益。     

Treatment of Bacterial Vaginosis with Metronidazole or Pivampicillin

In a double-blind randomized controlled trial from general practice, we assessed the efficacy of treatment with either metronidazole or pivampicillin in patients fulfilling the diagnostic criteria of bacterial vaginosis.

50 women were treated with metronidazole 500 mg twice daily and 54 with pivampicillin 700 mg twice daily, both for seven days.

Evaluated four weeks after the start of treatment, we found a significantly higher cure rate in the metronidazole group (90%) than in the pivampicillin group (69%) (p = 0.01). Cure was defined as lack of fulfilment of the diagnostic criteria of bacterial vaginosis. Test for confounding according to parity and complaint of vaginal discharge showed no influence.

Side-effects were significantly commoner in the pivampicillin group (28%) than in the metronidazole group (8%).

We consider that metronidazole is a potent drug in the treatment of bacterial vaginosis, with pivampicillin as a useful alternative.     

天津地区女性生殖道感染病原学分析

目的:了解天津地区性病门诊和妇科门诊女性患者的细菌性阴道病(BV)及其他性病患病情况及相关致病因素。方法:根据Biswas标准对546例女性患者进行细菌性阴道病的诊断及相关致病因素调查,同时进行其他性病病原学、血清学及组织学检测。结果:细菌性阴道病在性病门诊就诊人群的患病率为27.2%,在妇科门诊就诊人群的患病率为22.0%,两者间差异无统计学意义(P>0.05);混合感染共83例(63.4%);合并感染最多的为解脲脲原体(29.8%);流产史、宫内节育器使用、有多个性伴3个因素与BV发生有相关性。结论:细菌性阴道病不仅是妇科常见病之一,也是与性传播有关的疾病,发病率高且常合并其他性传播病原体感染,故应在高危人群中积极开展筛查工作。     

阴道加德纳菌致病株的检测

应用聚合酶链反应（ＰＣＲ）法检测阴道加德纳菌（Ｇ．Ｖａｇ）致病株,探讨其临床诊断价值。在ＩＴＳ－２３ｓｒＲＮＡ基因上设计一对特异性引物Ｐ１／Ｐ２,建立ＰＣＲ反应体系,特异地扩增Ｇ．Ｖａｇ致病株。结果Ｇ．Ｖａｇ扩增片段４３３ｂｐ,１４１例有临床症状者检出３６例阳性,阳性率２５５％,１２９例无症状对照组检出６例阳性,阳性率４６％,两者比较差异有显著性。该ＰＣＲ反应体系特异地检测Ｇ．Ｖａｇ致病株,为临床诊断及其致病性的研究提供了新的检测方法     

Clinical diagnosis of bacterial vaginosis

Bacterial vaginosis (often called nonspecific vaginitis or gardnerella vaginitis) is an incompletely understood disease whose initial diagnosis is often one of exclusion made when no trichomonads, yeast, or evidence of cervicitis is found during the initial examination of a woman complaining of a vaginal discharge. To increase the accuracy of the initial diagnosis, specific criteria were used before the clinical diagnosis of bacterial vaginosis was made. The presence of three of the following four criteria was necessary: 1) vaginal pH greater than 4.5; 2) clue cells on the saline wet mount; 3) thin, homogeneous-appearing discharge; or 4) positive potassium hydroxide "whiff test." A study on 100 consecutive women presenting to the emergency department with vaginal symptoms was done. Of those women meeting the criteria, 93% (54/58) obtained relief of their symptoms by treatment with metronidazole. Of those women not meeting the criteria, only 24% (10/42) were cured (P less than .001). The sensitivity, specificity, and total error rates of these criteria were 84, 89, and 14%, respectively.     

阴道加德纳菌在细菌性阴道病患者及正常女性生殖道中的分布

目的 了解阴道加德纳菌(Gardnerella vagihalis,GV)在细菌性阴道病(Bacterial vaginitis,BV)的感染率以及在正常女性生殖道内的携带情况。方法 应用BV国际四项诊断标准、革兰染色及分离培养,对350例BV患及220例正常女性的阴道分泌物进行调查研究。结果 GV在BV患中检出率为57．14％;在正常妇女中检出率为13．64％。结论 GV在BV和正常妇女中的检出率有显差异,证明它是细菌性阴道病的主要致病菌之一。     

唾液酸酶测定对诊断细菌性阴道病价值的探讨

目的 :探讨唾液酸酶测定法诊断细菌性阴道病的价值。方法 :取阴道分泌物行 p H、氨试验、涂片找线索细胞 ;BVBlue唾液酸酶测定试验 ;阴道加德纳菌免疫荧光试验。结果 :BV Blue唾液酸酶试验的敏感性、特异性、阳性预期值、阴性预期值分别为 99.4 %、97.8%、97.0 %、99.6 %。 BV Blue试验在检测细菌性阴道病上和传统的 Amsel四步法试验相比无显著性差异 (χ2 =0 .0 8,P>0 .0 5 ) ,且不受阴道毛滴虫病、生殖器念珠菌病、淋病、支原体感染等的影响 (P>0 .0 5 )。结论 :采用 BV Blue唾液酸酶测定检测细菌性阴道病简便、快速、可靠、结果易判读 ,不失为一种临床上可行的好方法。     

两种方法在细菌性阴道病诊断中的比较分析

目的比较分析检测和传统方法在细菌性阴道病（BV）诊断中的应用效果。方法用BV快速检测试剂盒和两种方法对200例患者的阴道分泌物进行检测。结果两种方法的检测结果,差异无统计学意义（P〉0．05）。结论传统方法较为繁琐,且要求操作者有较高技能、主观因素多、标准化程度差,但可作为确诊依据之一,BV快速检测试剂盒检测阴道分泌物方法可靠、易学、快速、简便,二者结合更能提高工作效率。     

某些理化因素对阴道加德纳菌生长的影响

测定阴道加德纳菌（GV）在干燥、湿热及常用消毒剂的条件下的抵抗力，发现该菌对湿热抵抗力弱，对干燥抵抗力可由于温度、湿度不同而有差异，对多种消毒剂的抵抗力也不同，这对于了解GV的生物学性状，选择消毒剂处理污染物和临床标本以及治疗方面均有意义。