281例宫颈上皮内瘤变患者阴道微生态研究

目的:通过281例宫颈上皮内瘤变(CIN)患者宫颈局部阴道微生态研究,揭示其发病特点,为药物干预,恢复宫颈局部阴道微生态平衡、阻断CIN发展演化提供依据。方法:取患者阴道分泌物行PH值测定、革兰染色后进行微生态评价(观察假丝酵母菌孢子及菌丝、阴道毛滴虫、线索细胞、加德纳菌、脓细胞、乳酸杆菌及菌群的多样性、密集度),同时取宫颈管分泌物检测支原体及沙眼衣原体,进而了解CIN患者宫颈局部阴道微生态特点。结果:CIN患者阴道微生态失调的总检出率为68.68%,线索细胞在CIN患者阴道分泌物涂片中的检出率最高,滴虫次之。沙眼衣原体(CT)在宫颈管病原体中检出率最高,解脲脲原体(Uu)次之,说明线索细胞、滴虫、沙眼衣原体及解脲脲原体感染导致的阴道微生态失衡极有可能与CIN发病有关,假丝酵母菌及人型支原体感染与CIN关系不大。CIN患者阴道乳酸杆菌总检出率不高,PH值呈异常升高趋势。

Study on vaginal microecosystem of 281 patients with cervical intraepithelial neoplasia

Objective: To reveal the characteristics of cervical intraepithelial neoplasia(CIN) by researching the vaginal microecosystem of 281 patients with CIN,provide a basis for drug intervention,recovery of balance of cervical-vaginal microecosystem and block of CIN development.Methods: Vaginal secretion samples of the patients were obtained to detect pH value,microecosystem evaluation was conducted after Gram staining,the spores and hyphae of Candida mycoderma bacteria,the diversities and intensities of Trichomonas vaginalis,clue cells,Gardnerella vaginalis,pyocytes,Lactobacillus and flora were observed;secretion samples of cervical canals were obtained to detect mycoplasma and Chlamydia trachomatis(CT),and then the characteristics of cervical-vaginal microecosystem of CIN patients were studied.Results: The total detection rate of vaginal microecological imbalance in patients with CIN was 68.68%,the detection rate of clue cells in smears of vaginal secretions of CIN patients was the highest,followed by trichomonad.The detection rate of CT in cervical canals was the highest,followed by Ureaplasma urealyticum(Uu).Conclusion: Vaginal microecological imbalance induced by clue cells,trichomonad,CT and Uu infection might be correlated with occurrence of CIN,there was no correlation between Candida mycoderma bacteria and Mycoplasma hominis infection and CIN.The total detection rate of vaginal lactobacillus in CIN patients was not high,pH value showed an abnormal increasing trend.