Zhu Yu-Xia, Li Ting, Fan Shang-Rong, Liu Xiao-Ping, Liang Yi-Heng, Liu Ping
Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
Shantou University Medical College, Shantou, Guangdong, 515041, China.
Health Qual Life Outcomes. 2016 Apr 29;14:65. doi: 10.1186/s12955-016-0470-2.
Recurrent vulvovaginal candidiasis (RVVC) has a poor therapeutic outcome and a severe impact on women and their partners, both physically and psychologically. Health-related quality of life (HRQOL) is significantly affected in patients with RVVC; however, little is known about HRQOL in patients with this disease. In this study, we aim to identify the clinical and mycological characteristics of women with RVVC and the effects of RVVC on women's HRQOL.
We designed this study as a comparative cross-sectional study. The Short-Form Health Survey (SF-36) was used to measure HRQOL in 102 patients with RVVC and 101 women seeking general health care (controls). RVVC was defined as four or more episodes of proven VVC in the previous 12-month period. VVC was defined as vulvar itching, burning, erythema, vaginal discharge, pseudohyphae or blastoconidia on a wet 10 % potassium hydroxide (KOH)-treated vaginal slide and a positive Candida culture. Group comparisons were conducted with independent samples t test. Correlation analysis was performed on the variables.
The mean age at first diagnosis of the patients with RVVC was 30.96 years (SD 5.38), and the mean age of the controls was 29.75 years (SD 5.83; p > 0.05). The duration of the patients' complaints varied from 6 months to 10 years, with a mean duration of 22.28 (±21.75) months. The most common complaints were increased vaginal discharge (102 cases, 100 %), itching (97 cases, 95.1 %), dyspareunia (65 cases, 63.7 %), burning (79 cases, 77.5 %) and erythema (25 cases, 24.5 %). C. albicans was the predominant Candida species (86 strains, 84.3 %) in the patients, followed by C. glabrata (12 strains, 11.8 %). C. parapsilosis (1 strain, 0.9 %), C. tropicalis (1 strain, 0.9 %), C. krusei (1 strain, 0.9 %) and C. lusitaniae (1 strain, 0.9 %). The mean SF-36 dimension scores for physical function, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health were significantly lower in the patients with RVVC than in the controls (85.20, 61.39, 77.79, 54.95, 53.17, 67.89, 52.48 and 59.17 vs. 90.20, 80.87, 87.08, 67.38, 59.69, 79.86, 68.01 and 65.38). The physical composite and mental composite scores of the patients with RVVC were 63.06 and 64.87, respectively, which were lower than those of the controls (75.01 and 74.87; p < 0.05).
Nearly all of the patients with RVVC had clinical symptoms. In our sample, RVVC was mainly caused by C. albicans. RVVC has negative effects on women's HRQOL, as indicated by lower physical and mental composite scores among the RVVC group compared with controls.
复发性外阴阴道念珠菌病（RVVC）治疗效果不佳，对女性及其伴侣的身体和心理均有严重影响。RVVC患者的健康相关生活质量（HRQOL）受到显著影响；然而，对于该疾病患者的HRQOL了解甚少。在本研究中，我们旨在确定RVVC女性患者的临床和真菌学特征以及RVVC对女性HRQOL的影响。
我们将本研究设计为一项比较性横断面研究。采用简短健康调查问卷（SF - 36）对102例RVVC患者和101例寻求普通医疗保健的女性（对照组）的HRQOL进行测量。RVVC定义为在过去12个月内有4次或更多次经证实的VVC发作。VVC定义为外阴瘙痒、烧灼感、红斑、阴道分泌物增多，在10%氢氧化钾（KOH）湿片处理的阴道涂片上发现假菌丝或芽生孢子，且念珠菌培养阳性。采用独立样本t检验进行组间比较。对变量进行相关性分析。
RVVC患者首次诊断时的平均年龄为30.96岁（标准差5.38），对照组的平均年龄为29.75岁（标准差5.83；p>0.05）。患者主诉的持续时间从6个月到10年不等，平均持续时间为22.28（±21.75）个月。最常见的主诉为阴道分泌物增多（102例，100%）、瘙痒（97例，95.1%）、性交困难（65例，63.7%）、烧灼感（79例，77.5%）和红斑（25例，24.5%）。白色念珠菌是患者中主要的念珠菌种类（86株，84.3%），其次是光滑念珠菌（12株，11.8%）。近平滑念珠菌（1株，0.9%）、热带念珠菌（1株，0.9%）、克柔念珠菌（1株，0.9%）和葡萄牙念珠菌（1株，0.9%）。RVVC患者的SF - 36各维度平均得分，包括身体功能、身体角色、身体疼痛、总体健康、活力、社会功能、情感角色和心理健康，均显著低于对照组（分别为85.20、61.39、77.79、54.95、53.17、67.89、52.48和59.17，而对照组分别为90.20、80.87、87.08、67.38、59.69、79.86、68.01和65.38）。RVVC患者的身体综合得分和心理综合得分分别为63.06和64.87，低于对照组（分别为75.01和74.87；p<0.05）。
几乎所有RVVC患者都有临床症状。在我们的样本中，RVVC主要由白色念珠菌引起。与对照组相比，RVVC组较低的身体和心理综合得分表明，RVVC对女性的HRQOL有负面影响。
