Yue Xin-Ai, Chen Ping, Tang Yuanting, Wu Xiuli, Hu Zhengqiang
Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin Nanlu, Chengdu, 610041, Sichuan, China.
Arch Gynecol Obstet. 2015 Dec;292(6):1285-94. doi: 10.1007/s00404-015-3774-2. Epub 2015 Jun 4.
Vaginal microecological environment is an important factor of recurrent vulvovaginal candidiasis (RVVC). This study was undertaken to investigate dynamic changes of vaginal microecosystem in patients with RVVC.
Four hundred patients with VVC and 400 healthy women of reproductive age who admitted to the hospital from January 2012 to December 2013 were evaluated retrospectively. Vaginal microecological factors were evaluated before and after treatment until no recurrence, including vaginal cleanliness, white blood cells, Lactobacillus, Lactobacillus classification, bacteria density, flora diversity, Nugent scores, etc. The grouping was done according to the recurrence of the disease. Every time after treatment, the relapsing patients were defined as case group and the cured patients without recurrence were defined as control group. The differences in the results between the case and the control groups were analyzed by t test.
With the development of RVVC, the ages of all case groups were lower than the corresponding control groups. In different stages of the disease, the bacteria density of the case groups and their corresponding control groups had no significant difference (P > 0.05). Most of the microecological indicators of the first occurring group were significantly different (P < 0.05) from that of the control group. In the recurrence groups, only a few indicators were significantly different from the control groups. The values of all vaginal microecological indicators (except Lactobacillus) of all case groups were higher than that of the control groups. The values of Lactobacillus of all RVVC case groups were lower than that of the RVVC control groups.
There were vaginal microecological imbalances in all developing stages of RVVC. As for vaginal flora, diverse sorts changed to normal Lactobacillus dominantly with the development of RVVC. In the first occurrence of RVVC, after antifungal treatment, Lactobacillus is suggested to be timely supplemented to restore vaginal microecological balance.
阴道微生态环境是复发性外阴阴道假丝酵母菌病（RVVC）的重要影响因素。本研究旨在探讨RVVC患者阴道微生态系统的动态变化。
回顾性分析2012年1月至2013年12月期间收治的400例VVC患者和400例健康育龄妇女。在治疗前后直至无复发时评估阴道微生态因素，包括阴道清洁度、白细胞、乳酸杆菌、乳酸杆菌分类、细菌密度、菌群多样性、Nugent评分等。根据疾病复发情况进行分组。每次治疗后，将复发患者定义为病例组，未复发的治愈患者定义为对照组。采用t检验分析病例组和对照组结果的差异。
随着RVVC病情发展，各病例组年龄均低于相应对照组。在疾病不同阶段，病例组及其相应对照组的细菌密度无显著差异（P>0.05）。初发组的大多数微生态指标与对照组有显著差异（P<0.05）。在复发组中，只有少数指标与对照组有显著差异。所有病例组的所有阴道微生态指标（除乳酸杆菌外）值均高于对照组。所有RVVC病例组的乳酸杆菌值均低于RVVC对照组。
RVVC各发展阶段均存在阴道微生态失衡。就阴道菌群而言，随着RVVC病情发展，多种菌群转变为以正常乳酸杆菌为主。在RVVC初发时，抗真菌治疗后，建议及时补充乳酸杆菌以恢复阴道微生态平衡。
