【作者】 陈晓伟；

【导师】 郑华；

【作者基本信息】 吉林大学 ， 临床医学， 2009， 硕士

【摘要】 解脲支原体(Uu)感染、细菌性阴道病(BV)都是常见的导致女性泌尿生殖道炎症的重要原因。为了探讨二者的相关性,我们对2008年6月-2009年1月到吉林大学第一医院皮肤病性病门诊就诊的1491例患者进行了Uu、BV的检测,并同时检测Mh、NG、CT、念珠菌及阴道毛滴虫。其中Uu阳性者共696例,BV247例,Mh111例,NG10例,CT19例,念珠菌阳性者201例,阴道毛滴虫阳性者5例。其中Uu合并BV阳性者156例,Uu合并Mh阳性者89例,Uu合并NG者3例,Uu合并CT者11例,Uu合并念珠菌阳性者78例。Uu阳性的696例纳入观察组,合并BV阳性的为156例,Uu阴性的795例作为对照组,合并BV阳性的为91例,两组比较,观察组BV的阳性率(22.41%)明显高于对照组BV的阳性率(11.45%),差异有显著性(P<0.01),Uu感染者更易患细菌性阴道病。观察组BV的阳性率先随着年龄的增加而增高,31-40岁左右到达高峰,随后又随着年龄的增长而降低,对照组中BV的阳性率随着年龄的增长而降低,与年龄呈负相关。观察组与对照组相比,以21-30岁组和31-40岁组BV的阳性率高于对照组中BV的阳性率(P<0.01),差异有显著性。职业分布在两组间差异无显著性。观察组中采用屏障避孕法BV的检出率明显比非屏障避孕法低。对照组中各避孕方式间无明显差别。观察组BV阳性患者以阴道清洁度Ⅲ度和阴道清洁度Ⅳ度为主,对照组中BV患者以阴道清洁度Ⅱ度为主。所以,女性生殖道Uu感染可以增加BV的发病率;女性生殖道Uu感染与BV之间存在相关性;屏障避孕法可以降低Uu患者BV的发病率;女性生殖道Uu感染合并BV感染时,阴道清洁度下降。更多还原

【Abstract】 Infection of ureaplasma urealyticum and bacterial vaginosis are two common reasons in the consequence of women urogenital inflammation. Uu has two serotypes, one is parvum biovar, and the other is urealyticum biovar. In many healthy women, Uu has the existence of asymptomatic carrier status in reproductive tract; when Uu colonization reaches a certain number or the serotype is pathogenic, clinical symptoms appear. In women, the organism can cause urinary tract inflammation, infertility, while in the pregnant ones, it may results in miscarriage, premature delivery, stillbirth, intrauterine growth retardation, premature rupture of membranes, low birth weight, and other development disoders, after delivery by transmission from mother to newborn, can cause neonatal diseases, too. Uu can be transmitted by sexual contact, which can also get the partner infected and the corresponding clinical syptoms, accordingly it’s classified to sexually trasimmited diseases. GV is the major pathogens to BV. There are normal floras in women’s vagina, which contributes a natural biological barrier. Any reason that can reduce the lactobacilli and disturb the environment of flora may help increasing the number of GV. BV can cause cervicitis, pelvitic inflammatory diseases and salpingitis, also may cause adverse pregnancy and neonatal sepsis. The reason that cause the disturbance of vaginal flora, such as, menstrual cycle, hormone levels in vivo, with other infections, sexual activity, ways of contraception, using of antibiotics, et al. Although BV is still not classified as sexually transmitted disease, it can be transmitted by sexual contact..Uu is the most common pathogen of women STD--non-gonococcal cervicitis, while BV is common in vaginitis. In Vogel’s research, he found that, Uu is a independent factor of fetal growth and lowbirth weight, combined BV can worsen the consequence. However, we can hardly find research about the clinical relevance of Uu and BV. In the refractory infection of Uu, also the recurrent infection ones, is there a part that BV takes in, by means of changing the normal vaginal flora, damaging the vagina’s natural barrier, getting Uu infection more easier. What kind of relationship between them, In order to explore the correlation between them, we enrolled 1491 cases female patients who came to Dermatology and Sexually transimitted disease outpatient of The First Hospital of Jilin University, testing them for Uu,Mh,BV,NG,CT,Candida albicans and Trichomoniasis. Through the analysis of BV positive cases in both Uu positive group and Uu negative group; meanwhile, compare Uu positive cases in both BV positive and BV negative group.ALL selected cases were female, with clinically increased vaginal discharege, smelly leucorrhea, lower abdominal discomfort, genital itching and other symptoms. They should have no administration of antibio tics sutemicly and locally in 2 weeks before, no sex in 3 days. The cases who had organic disease of the urogenital system, in the menstral period, pregnancy breast-feeding, have IUD, as well as the ones who did wash the vagina in 3 days, were excluded. A total of 1491 cases of selected cases, aged 20 to 56 years old, average 35.5 years old, with history duration 2 weeks to 2years, average 3 months. We get swab from posterior formix vaginal secretions in all cases for Trichomonas vaginalis and Candida detection, swab from cervix secretions for testing Uu,Mh,CT,NG.Results: We detect 696 cases Uu positive patients, 247 cases for BV, 111 cases for Mh,10cases for NG, 19 cases for CT, 201 cases for fungus and 5 cases for trichomoniasis. In Uu positive cases, there are 156 BV positive cases, 89 Mh positive cases, 3 NG positive cases, 11 CT positive cases, and 78 Candida-positive cases. In the 696 cases Uu positive group, we have 156 cases who with BV positive, either; in the 795 cases Uu negative group, we get 91 cases with BV positive, the rate of BV positive in Uu positive group(22.41%) is higher than that in Uu negative group(11.45%), P<0.01. In the 21-30-year-old group and 31-40 year-old-group, the rate of BV positive in the observer group is higher than that of control group. There is no significant difference of occupational distribution in the two groups. Using of barrier contraception can significantly low down the BV positive rate than non-barrier contraception, while the control group has no significant difference in contraceptive methods. The vaginal sanitary degree areⅢ,Ⅳin observation group,Ⅱin control group.Conclusions: People who gets Uu infection is easy to get BV. There is relevance between Uu infection and BV. Barrier contraception can reduce the Uu infection and incidence of BV. Vaginal sanitary degree declines in co-infection of Uu and BV patients.更多还原