Eckert L O, Koutsky L A, Kiviat N B, Krone M R, Stevens C E, Eschenbach D A
Department of Obstetrics and Gynecology, University of Washington, Seattle, USA.
Obstet Gynecol. 1995 Sep;86(3):360-6. doi: 10.1016/0029-7844(95)00196-X.
To determine the correlation between inflammation detected on Papanicolaou smear and specific lower genital tract agents, and, based on these findings, to develop recommendations for follow-up tests and treatment of young women with inflammation on smears.
A high-risk population of 779 randomly selected women attending a sexually transmitted disease (STD) clinic and a low-risk population of 1050 consecutive women presenting for annual examination at a university student health center underwent a standardized history and gynecologic examination. Univariate and multivariate analyses, focusing on the association between dense inflammation on Papanicolaou smear and specific lower genital tract pathogens or findings on cervical examination, were done for each population.
Dense inflammation was present on the Papanicolaou smear of 256 (33%) of the 779 women in the STD clinic and 200 (19%) of 1050 students. Dense inflammation on Papanicolaou smear was independently associated with mucopus, cervical ectopy, cervical infection with Neisseria gonorrhoeae, Chlamydia trachomatis, herpes simplex virus (HSV), and vaginal infection by Trichomonas vaginalis in the STD population; in the student population, it was associated with cervical ectopy, C trachomatis, and mucopus.
Although dense inflammation on Papanicolaou smear was a common finding in both the high- and low-risk populations, about half of the inflammation detected in the high-risk setting was associated with a specific microbial organism (C trachomatis, N gonorrhoeae, HSV, or T vaginalis), whereas less than 10% of the dense inflammation detected in the low-risk setting was linked with a specific pathogen (C trachomatis). In both settings, a substantial population of sexually active women had dense inflammation associated with cervical ectopy but none of the specific organisms evaluated in this study.
确定巴氏涂片检测出的炎症与特定下生殖道病原体之间的相关性，并基于这些发现，为涂片有炎症的年轻女性制定后续检查和治疗建议。
对779名随机选取的就诊于性传播疾病（STD）诊所的高危女性人群以及1050名在大学生健康中心进行年度检查的连续就诊的低危女性人群进行标准化病史采集和妇科检查。针对每一组人群，进行单因素和多因素分析，重点关注巴氏涂片上的密集炎症与特定下生殖道病原体或宫颈检查结果之间的关联。
STD诊所的779名女性中，256名（33%）巴氏涂片上有密集炎症；1050名学生中，200名（19%）有密集炎症。在STD人群中，巴氏涂片上的密集炎症与黏液脓性分泌物、宫颈外翻、淋病奈瑟菌、沙眼衣原体、单纯疱疹病毒（HSV）宫颈感染以及阴道毛滴虫阴道感染独立相关；在学生人群中，它与宫颈外翻、沙眼衣原体和黏液脓性分泌物相关。
尽管巴氏涂片上的密集炎症在高危和低危人群中都是常见发现，但在高危人群中检测到的炎症约有一半与特定微生物（沙眼衣原体、淋病奈瑟菌、HSV或阴道毛滴虫）有关，而在低危人群中检测到的密集炎症不到10%与特定病原体（沙眼衣原体）有关。在这两种情况下，相当一部分性活跃女性有与宫颈外翻相关的密集炎症，但本研究中评估的特定病原体均未检出。
