患有阴道炎/阴道病的孕妇和非孕妇以及对照组阴道分泌物中的白细胞酯酶活性。
Leukocyte esterase activity in vaginal fluid of pregnant and non-pregnant women with vaginitis/vaginosis and in controls.
作者信息
Mårdh Per-Anders, Novikova Natalia, Niklasson Ola, Bekassy Zoltan, Skude Lennart
机构信息
Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden.
出版信息
Infect Dis Obstet Gynecol. 2003;11(1):19-26. doi: 10.1155/S1064744903000036.
OBJECTIVES
To determine the leukocyte esterase (LE) activity in vaginal lavage fluid of women with acute and recurrent vulvovaginal candidosis (VVC and RVVC respectively), bacterial vaginosis (BV), and in pregnant and non-pregnant women without evidence of the three conditions. Also to compare the result of LE tests in women consulting at different weeks in the cycle and trimesters of pregnancy. The LE activity was correlated to vaginal pH, number of inflammatory cells in stained vaginal smears, type of predominating vaginal bacteria and presence of yeast morphotypes.
METHODS
One hundred and thirteen women with a history of RVVC, i.e. with at least four attacks of the condition during the previous year and who had consulted with an assumed new attack of the condition, were studied. Furthermore, we studied 16 women with VVC, 15 women with BV, and 27 women attending for control of cytological abnormalities, who all presented without evidence of either vaginitis or vaginosis. Finally, 73 pregnant women were investigated. The LE activity in vaginal fluid during different weeks in the cycle of 53 of the women was measured.
RESULTS
In the non-pregnant women, an increased LE activity was found in 96, 88, 73 and 56% of those with RVVC, VVC and BV and in the non-VVC/BV cases, respectively. In 73% of pregnant women in the second trimester, and 76% of those in the third, the LE test was positive. In all groups of non-pregnant women tested, the LE activity correlated with the number of leukocytes in vaginal smears, but it did not in those who were pregnant. There was no correlation between LE activity and week in cycle. The vaginal pH showed no correlation to LE activity in any of the groups studied.
CONCLUSIONS
The use of commercial LE dipsticks has a limited value in the differential diagnosis of RVVC, VVC and BV. There is no correlation between the LE activity in vaginal secretion on one hand and vaginal pH, week in the menstrual cycle and trimester in pregnancy on the other. Women with BV often have signs of inflammation as evidenced by a positive LE test and inflammatory cells in genital smears.
目的
测定急性和复发性外阴阴道念珠菌病（分别为VVC和RVVC）、细菌性阴道病（BV）患者以及无这三种疾病迹象的孕妇和非孕妇阴道灌洗液中的白细胞酯酶（LE）活性。同时比较在月经周期不同周数以及孕期不同阶段就诊的女性的LE检测结果。将LE活性与阴道pH值、阴道涂片染色后的炎症细胞数量、阴道优势菌类型以及酵母形态型的存在情况进行关联分析。
方法
对113名有RVVC病史的女性进行研究，即前一年至少有四次该病发作且此次因疑似新发作前来就诊。此外，我们还研究了16名VVC患者、15名BV患者以及27名因细胞学异常前来检查且均无阴道炎或阴道病迹象的女性。最后，对73名孕妇进行了调查。测定了53名女性在月经周期不同周数时阴道液中的LE活性。
结果
在非孕妇中，RVVC、VVC、BV患者以及非VVC/BV病例中LE活性升高的比例分别为96%、88%、73%和56%。在孕中期73%的孕妇以及孕晚期76%的孕妇中，LE检测呈阳性。在所有接受检测的非孕妇组中，LE活性与阴道涂片中的白细胞数量相关，但在孕妇中则不然。LE活性与月经周期周数之间无相关性。在所研究的任何组中，阴道pH值与LE活性均无相关性。
结论
使用商用LE试纸条在RVVC、VVC和BV的鉴别诊断中价值有限。一方面阴道分泌物中的LE活性与另一方面阴道pH值、月经周期周数和孕期阶段之间无相关性。BV患者通常有炎症迹象，LE检测呈阳性以及生殖道涂片中存在炎症细胞可证明这一点。
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