健康妇女和外阴阴道假丝酵母菌病患者阴道乳杆菌对阴道假丝酵母菌抑制作用的实验研究

目的:探讨正常健康和外阴阴道假丝酵母菌病(VVC)妇女阴道分泌物中分离的乳杆菌对假丝酵母菌生长的抑制。方法:健康正常(正常组)和VVC初发(VVC组)妇女各30名,通过定量采集阴道分泌物培养乳杆菌,观察阴道乳杆菌数量及菌种分布情况,并将获得的乳杆菌及VVC患者阴道分泌物中假丝酵母菌分离纯化及鉴定后,采用牛津杯法观察乳杆菌对假丝酵母菌生长的抑制作用,同时比较VVC组和正常组乳杆菌产H2O2能力的差异。结果:①乳杆菌检出率及菌种分布组间无统计学差异(P>0.05);②VVC组阴道乳杆菌数量的平均对数值与正常组相比显著减少(P<0.01);③阴道内乳杆菌BV试剂盒检测为阴性者,正常组显著高于VVC组(P<0.01);④正常组阴道分离的乳杆菌与VVC组比较,对白色和热带假丝酵母菌的生长抑制有统计学差异(P<0.05),对克柔假丝酵母菌的抑制无统计学差异(P>0.05);正常组分离的嗜酸乳杆菌与VVC组的比较,对白色和热带假丝酵母菌的生长抑制均有统计学差异(P<0.01,P<0.05),对克柔假丝酵母菌的生长抑制无统计学差异(P>0.05);但是正常组和VVC组分离的詹氏乳杆菌对上述3种假丝酵母菌的生长抑制均无统计学差异(P>0.05)。结论:①正常妇女与VVC患者阴道内乳杆菌检出率、菌种分布相似,均以嗜酸、詹氏乳杆菌为优势菌种;②VVC患者阴道乳杆菌的数量显著减少;③VVC组产生H2O2的能力下降,可能与VVC发生相关;④正常状态下阴道乳杆菌对假丝酵母菌抑制作用优于VVC感染状态,其中以嗜酸乳杆菌的抑菌作用最为明显。

In Vitro Inhibition of Vaginal Lactobacillus to Vaginal Candida in Healthy Women and Cases of Vulvovaginal Candidiasis

Objective: To investigate the difference of the growth inhibition of vaginal Lactobacilli to vaginal candida in healthy women and patients with vulvovaginal candidiasis(VVC).Methods: From 30 healthy women and 30 patients with VVC,the vaginal discharge was collected for the vaginal Lactobacilli to be cultured and isolated and purified to observe the distribution of vaginal Lactobacillus in the two groups.Candida from VVC patients was isolated and purified.After identification and classification,by the Oxford cup method the inhibitive effects on Candida growth of vaginal Lactobacilli from two groups were observed,and the differences in H2O2-production were compared.Results: 1) The distribution and the detection rate of vaginal Lactobacillus were not significantly different(P>0.05).2) The number of vaginal Lactobacillus(average logic value) in VVC patients was significantly less than that in healthy women(P<0.01).3) BV detection showed negative cases in the healthy group was significantly more than in VVC group(P<0.01).4) Variance analysis showed that the inhibition effect of vaginal Lactobacillus to candidas albicans and candidas tropicalis was significantly different between the two groups(P<0.05),while the difference in the inhibition effect of vaginal Lactobacillus on candidas krusei was not significantly different(P>0.05).The inhibition effect of L.acidophilus on candidas albicans and candidas tropicalis was significantly different between the two groups(P<0.01,P<0.05),while the difference in the inhibition effect on candidias krusei was not significantly different(P>0.05).There was no significant difference in the inhibition of L.jensenii among three kinds of Lactobacillus(P>0.05).Conclusion: 1) The detection rate and the distribution of common vaginal Lactobacilli between healthy women and VVC patients were just similar.The predominant species of the two groups were L.acidophilus and L.jensenii.2) The number of vaginal Lactobacillus decreased remarkably in VVC.3) The H2O2 production could be associated with the occurrence of VVC.4) The inhibition effect of Lactobacillus from the healthy vagina on white and tropical Candidas is superior to that of Lactobacillus from VVC cases,and L.acidophilus is the most effective in the inhibition.