阿姆斯勒（Amsel）标准与努金（Nugent）评分法对尼泊尔一家三级医院细菌性阴道病诊断的比较研究。
Comparative study of Amsel's criteria and Nugent scoring for diagnosis of bacterial vaginosis in a tertiary care hospital, Nepal.
机构信息
Department of Clinical Microbiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Department of Microbiology, Rajarshi Janak University, Janakpurdham, Nepal.
出版信息
BMC Infect Dis. 2021 Aug 17;21(1):825. doi: 10.1186/s12879-021-06562-1.
BACKGROUND
The most common pathological cause of abnormal vaginal discharge in reproductive-aged women is bacterial vaginosis (BV). Amsel's criteria and Nugent scoring systems are commonly employed approaches for the diagnosis of BV. Despite the Nugent scoring system being the gold standard method for diagnosing BV, Amsel's criteria are generally preferred in clinical setup owing to the fact Nugent scoring requires considerable time and expert microscopist. This study was conducted to determine the diagnostic value of Amsel's criteria by comparing it with the Nugent scoring system.
METHODS
This was a descriptive cross-sectional study conducted at Tribhuvan University Teaching Hospital, Nepal from October 2016 to September 2017. Vaginal specimens were collected from a total of 141 women presenting with abnormal vaginal discharge. The sensitivity, specificity, positive predictive value, and negative predictive value of Amsel's criteria were calculated, and each component of Amsel's criteria was compared to the Nugent scoring system.
RESULTS
The sensitivity, specificity, positive predictive value, and negative predictive value of Amsel's criteria were 50%, 98.2%, 87.5%, and 88.8% respectively. The clue cells showed 100% specificity and vaginal discharge with pH > 4.5 had 89.3% sensitivity while compared with Nugent's scoring system.
CONCLUSIONS
Amsel's criteria can be used as an adjunct method to Nugent scoring for the diagnosis of BV in the hands of skilled manpower in resources limited countries. The presence of clue cell and positive whiff test of Amsel's criteria shows good match with Nugent's score.
背景
在育龄期妇女中，导致异常阴道分泌物的最常见病理原因是细菌性阴道病（BV）。Amsel 标准和 Nugent 评分系统常用于 BV 的诊断。尽管 Nugent 评分系统是诊断 BV 的金标准方法，但由于 Nugent 评分需要相当多的时间和专家显微镜检查师，因此在临床环境中通常更倾向于使用 Amsel 标准。本研究旨在通过与 Nugent 评分系统比较来确定 Amsel 标准的诊断价值。
方法
这是 2016 年 10 月至 2017 年 9 月在尼泊尔特里布万大学教学医院进行的一项描述性横断面研究。共从 141 名出现异常阴道分泌物的女性中采集阴道标本。计算了 Amsel 标准的敏感性、特异性、阳性预测值和阴性预测值，并将 Amsel 标准的每个组成部分与 Nugent 评分系统进行比较。
结果
Amsel 标准的敏感性、特异性、阳性预测值和阴性预测值分别为 50%、98.2%、87.5%和 88.8%。线索细胞的特异性为 100%，阴道分泌物 pH 值>4.5 的敏感性为 89.3%，与 Nugent 评分系统相比。
结论
在资源有限的国家，熟练劳动力可将 Amsel 标准作为 Nugent 评分的辅助方法用于诊断 BV。Amsel 标准的线索细胞和阳性气味试验与 Nugent 评分具有良好的匹配度。
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