需氧菌性阴道炎临床微生态研究及治疗效果的探讨

目的研究需氧菌性阴道炎临床及微生态特征,并行治疗随访,为需氧菌性阴道炎的预防、治疗及预后评估提供帮助。方法前瞻性随机对照研究北京大学人民医院2013年1月至2013年4月门诊就诊的120例需氧菌性阴道炎,行阴道微生态评价,随机分组行药物治疗（一组口服左氧氟沙星,二组口服头孢呋辛,三组口服淀粉胶囊）并随访,停药后7～10d再次评估。结果患者年龄呈近似正态分布（P=0.190〉0.05）,阴道分泌物pH值以≥5.1为主（90.0%）,优势菌可为G＋球菌（45.8%）、G-杆菌（32.5%）、G＋杆菌（21.6%）。经治疗随访,一组、二组的症状、体征总体均有明显改善,阴道微生态恢复正常比例（35.1%、31.5%）显著高于三组（5.8%）,差异有统计学意义（P〈0.05）,三组疗效行Radit分析,一、二组均较三组疗效好,差异有统计学意义（P〈0.05）,而一、二组间差异无统计学意义（P〉0.05）。结论需氧菌性阴道炎阴道微生态改变表现为pH值升高、优势菌改变等,口服左氧氟沙星或头孢呋辛较对照组对需氧菌性阴道炎症状改善好,有效率高,可作为临床治疗的选择。

Clinical/Microbiological research and investigation of therapy effection aerobic vaginitis

Objective To study the clinical and microbiological feature of aerobic vaginitis （AV） and to provide prevention, treatment of patients with AV. Methods A prospective randomized control study was conducted on outpatient data of 120 patients with AV who were admitted to Peking University People＇ s Hospital from January 2013 to April 2013. After the first evaluation of their clinical situations and vaginal micro - ecological environment, subjects were divided randomly into three groups： Group I and Group 2 （experimental groups） received oral antibi- otics of either levofloxacin or cefuroxime, and Group 3 （control group） received oral starch capsules. The second e valuation was then carried out 7 - 10 days after the treatment. Results The age of all the patients was approximately normally distributed （P=0. 190〉 0.05）. Vaginal pH values of most patients （90. 0%） were equal to or greater than 5.1. The predominant flora consist of Gram - positive cocci （45.8%）, Gram - negative bacilli （32.5%） and Gram- positive bacilli （21.6%）. After 7 to 10 days of treatment, either symptoms or signs of Group and Group 2 showed obvious improvement, the recovery rates （35.1%, 31.5%） were remarkably higher than Group 3 （5.8%, P〉0.05）. Radit analysis showed that the curative effect of either Group 1 or Group 2 was significantly better than Group 3 （P〉 0. 05）, and no significant differences was found between Group 1 and Group 2 （P〉 0. 05）. Conclusions The pH value and predominant flora were changed in Aerobic vaginitis patients. Groups received oral antibiotics of either levofloxacin or cefuroxime achieved higher improvement than control group. Levoflxacin and cefuroxime may thus become clinical treatment options for patients with AV.