妊娠期糖尿病阴道微生态变化特征分析

目的探讨妊娠期糖尿病（GDM）孕妇阴道微生态变化特征。方法随机选取2011年11月-2013年1月正常产检的GDM孕妇256例为实验组，另选取同期产检正常孕妇221例和正常妇科体检妇女198例为对照组，对两组行阴道分泌物涂片Nugent评分及阴道菌群检查，进行微生态评价。结果阴道pH值在GDM、正常妊娠及体检组分别为（3．46±0．23）、（3．62±0．20）及（4．22±0．34），妊娠组低于非孕组，差异显著（P〈0．01）；乳杆菌检出率分别为91．1％、87．5％及77．8％，妊娠组高于正常体检组（P〈0．05）；外阴阴道假丝酵母菌病（VVC）检出率分别为33．6％、22．5％及18．2％，GDM组高于对照组（P〈0．05）；细菌性阴道病（BV）发生率11．1％、13．2％及34．0％，GDM组与正常妊娠组比较无差异（P〉0．05），但妊娠组低于正常体检组（P〈0．01）。结论GDM孕妇阴道微生态发生改变，应积极控制血糖水平，防治不良妊娠结局。

Analysis of state of vaginal microecology of gestation diabetes mellitus

bjective To analyze the vaginal microecology state of women with gestation diabetes mellitus （GDM） Methods Totally 256 women with GDM,221 normal pregnant women and 196 medical examination women were se- lected randomly. Vulvovaginal secretions from them were detected for vagina pH, lactobacilli distribution, Nugent Score and checting the vagina flora, and evaluate the microecology state. Results Vagina pH were （ 3.46 ± 0. 23 ）, （3.62 ± 0. 20）and （4. 22 ± 0. 34）in three groups;The ratio of lactobacilli detection in three groups were 91.1% ,87.5% and 77. 8% ;The ratio of candidal vaginitis were 33.6% ,22. 5% and 18.2% ;The ratio of bacterial vaginosis were 11.1%, 13.2% and 34.0%; The ratio of normal vaginal microecology were 71.8%, 69.2% and 52.5% in three groups. Conclusion The vaginal microecology of women with gestation diabetes mellitus would be changed, so it should be manipulation actively serum glucose level in normal range.