刚入伍的有性经验和无性经验年轻女性中的细菌性阴道病
Bacterial vaginosis in sexually experienced and non-sexually experienced young women entering the military.
作者信息
Yen Sophia, Shafer Mary-Ann, Moncada Jeanne, Campbell Christopher J, Flinn Scott D, Boyer Cherrie B
机构信息
Division of Adolescent Medicine, Department of Pediatrics, University of California, San Francisco, California, USA.
出版信息
Obstet Gynecol. 2003 Nov;102(5 Pt 1):927-33. doi: 10.1016/s0029-7844(03)00858-5.
OBJECTIVE
To estimate the prevalence of bacterial vaginosis by Nugent Gram stain criteria in a nonclinic national sample of young women entering recruit training; to examine clinical associations with bacterial vaginosis; and to evaluate the performance of a pH test card and Papanicolaou smear against Gram stain as screening tools for bacterial vaginosis.
METHODS
A cross-sectional study of 1938 women was conducted. Self-collected vaginal swabs were applied to a colorimetric pH test card and a glass slide for Gram stain evaluation according to the Nugent criteria. Papanicolaou smears and samples for sexually transmitted diseases screening were collected during routine entry pelvic examinations.
RESULTS
Bacterial vaginosis prevalence was 27%, with 28% in sexually experienced and 18% in non-sexually experienced women (P = .001). Bacterial vaginosis prevalence was 11% in Asian/Pacific Islanders, which was lower than in other nonwhite ethnic groups (P = .004). Clinically, bacterial vaginosis was directly related to multiple sexual partners (P = .026), self-report of vaginal discharge (P = .001), self-report of vaginal odor (P < .001), and concurrent Chlamydia trachomatis infection (P = .002), and inversely related to hormonal contraceptive use (P = .013). Vaginal discharge did not achieve statistical significance in multivariate analysis. Compared with the Nugent criteria, the sensitivities and specificities for bacterial vaginosis diagnosis were as follows: colorimetric pH test: 72% and 67%; Papanicolaou smear: 72% and 79%, respectively.
CONCLUSION
Among these diverse young women, bacterial vaginosis occurs commonly in both sexually experienced and inexperienced young women and differs by race and ethnicity. The pH colorimetric test and Papanicolaou smear performed moderately well as screening tools for bacterial vaginosis. The inverse relationship of bacterial vaginosis with hormonal contraceptive use and its direct relationship with C. trachomatis need further study.
目的
采用纽金特革兰氏染色标准评估参加新兵训练的年轻女性非临床全国样本中细菌性阴道病的患病率；研究与细菌性阴道病相关的临床因素；并评估pH试纸和巴氏涂片作为细菌性阴道病筛查工具相对于革兰氏染色的性能。
方法
对1938名女性进行了横断面研究。自行采集的阴道拭子用于比色pH试纸检测，并根据纽金特标准涂片于载玻片上进行革兰氏染色评估。在常规入伍盆腔检查期间采集巴氏涂片和性传播疾病筛查样本。
结果
细菌性阴道病患病率为27%，有性经历的女性中为28%，无性经历的女性中为18%（P = 0.001）。亚洲/太平洋岛民中细菌性阴道病患病率为11%，低于其他非白人种族（P = 0.004）。临床上，细菌性阴道病与多个性伴侣直接相关（P = 0.026）、白带自述（P = 0.总氮（TN）、总磷（TP）、化学需氧量（COD）、氨氮（NH₃-N）是水体中常见的污染物指标，其含量高低直接反映水体受污染程度。某污水处理厂进水水质监测数据显示，TN浓度为45mg/L，TP浓度为5mg/L，COD浓度为300mg/L，NH₃-N浓度为30mg/L。出水水质监测数据显示，TN浓度为15mg/L，TP浓度为1mg/L，COD浓度为60mg/L，NH₃-N浓度为10mg/L。请计算该厂对各污染物的去除率。
计算过程
总氮（TN）去除率
[
\begin{align*}
TN去除率&=\frac{进水TN浓度 - 出水TN浓度}{进水TN浓度}×100%\
&=\frac{45 - 15}{45}×100%\
&=\frac{30}{45}×100%\
&\approx66.7%
\end{align*}
]
总磷（TP）去除率
[
\begin{align*}
TP去除率&=\frac{进水TP浓度 - 出水TP浓度}{进水TP浓度}×100%\
&=\frac{5 - 1}{5}×100%\
&=\frac{4}{5}×100%\
&=80%
\end{align*}
]
化学需氧量（COD）去除率
[
\begin{align*}
COD去除率&=\frac{进水COD浓度 - 出水COD浓度}{进水COD浓度}×100%\
&=\frac{300 - 60}{300}×100%\
&=\frac{240}{300}×100%\
&=80%
\end{align*}
]
氨氮（NH₃-N）去除率
[
\begin{align*}
NH₃-N去除率&=\frac{进水NH₃-N浓度 - 出水NH₃-N浓度}{进水NH₃-N浓度}×100%\
&=\frac{30 - 10}{30}×100%\
&=\frac{20}{30}×100%\
&\approx66.7%
\end{align*}
]
答案
该厂对总氮（TN）的去除率约为66.7%，对总磷（TP）的去除率为80%，对化学需氧量（COD）的去除率为80%，对氨氮（NH₃-N）的去除率约为66.7%。 001）、白带异味自述（P < 0.001）以及沙眼衣原体并发感染（P = 0.002）直接相关，与使用激素避孕药呈负相关（P = 0.013）。白带在多因素分析中未达到统计学显著性。与纽金特标准相比，细菌性阴道病诊断的敏感性和特异性如下：比色pH试纸检测：72%和67%；巴氏涂片：分别为72%和79%。
结论
在这些不同的年轻女性中，细菌性阴道病在有性经历和无性经历的年轻女性中均普遍存在，且因种族和民族而异。pH比色试验和巴氏涂片作为细菌性阴道病筛查工具表现中等。细菌性阴道病与激素避孕药使用的负相关关系及其与沙眼衣原体的正相关关系需要进一步研究。
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