Eschenbach D A, Hillier S, Critchlow C, Stevens C, DeRouen T, Holmes K K
Department of Obstetrics and Gynecology, University of Washington, Seattle 98195.
Am J Obstet Gynecol. 1988 Apr;158(4):819-28. doi: 10.1016/0002-9378(88)90078-6.
Among 640 randomly selected women who were attending a sexually transmitted disease clinic and did not have trichomoniasis, 33% had bacterial vaginosis as defined by a composite of four clinical criteria: (1) Vaginal discharge was homogeneous; (2) vaginal discharge had a pH greater than or equal to 4.7; (3) vaginal discharge had an amine-like odor when mixed with 10% potassium hydroxide; (4) vaginal discharge contained clue cells representing greater than or equal to 20% of vaginal epithelial cells. Previously published Gram stain criteria for bacterial vaginosis correlated better than results of semiquantitative cultures for Gardnerella vaginalis with presence or absence of clue cells and with composite clinical criteria. Of 293 women with bacterial vaginosis by Gram stain criteria, 65% had symptoms of increased vaginal discharge and/or vaginal malodor, while 74% had signs of characteristic homogeneous vaginal discharge or amine-like odor. Elevated vaginal pH was the least specific and amine-like odor the least sensitive sign of bacterial vaginosis. Gram stain criteria for bacterial vaginosis were not associated with the concentrations of endocervical or vaginal inflammatory cells but were significantly associated with a clinical diagnosis of pelvic inflammatory disease. After adjusting for coinfection, sexual behavior, and other variables, bacterial vaginosis remained associated with adnexal tenderness (odds ratio = 9.2, p = 0.04). Bacterial vaginosis, previously implicated as a risk factor for obstetric infections, may be a risk factor for pelvic inflammatory disease.
在640名随机挑选的、前往性传播疾病诊所就诊且未患滴虫病的女性中，33%患有细菌性阴道病，其诊断依据为四项临床标准的综合判定：（1）阴道分泌物均质；（2）阴道分泌物pH值大于或等于4.7；（3）阴道分泌物与10%氢氧化钾混合时有胺样气味；（4）阴道分泌物中线索细胞占阴道上皮细胞的比例大于或等于20%。先前发表的细菌性阴道病革兰氏染色标准，与阴道加德纳菌半定量培养结果相比，在有无线索细胞以及综合临床标准方面的相关性更好。在293名依据革兰氏染色标准诊断为细菌性阴道病的女性中，65%有阴道分泌物增多和/或阴道异味的症状，而74%有特征性均质阴道分泌物或胺样气味的体征。阴道pH值升高是细菌性阴道病最不具特异性的体征，胺样气味是最不敏感的体征。细菌性阴道病的革兰氏染色标准与宫颈管或阴道炎症细胞浓度无关，但与盆腔炎的临床诊断显著相关。在对合并感染、性行为及其他变量进行校正后，细菌性阴道病仍与附件压痛相关（比值比=9.2，p=0.04）。细菌性阴道病先前被认为是产科感染风险因素，可能也是盆腔炎的风险因素。
