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目的:探讨常规行糖化血红蛋白A1(HBA1c)检测对治疗复发性外阴阴道假丝酵母菌病(RVVC)的指导价值。方法:将符合RVVC诊断标准的病人65例作为实验组,对照组60例为真菌学阴性的健康体检者及复发性细菌性阴道病(RBV)患者,对所有入选者行空腹及餐后2h血糖、血HBA1c检测并计算体重指数。将HBA1c≥5%的58例RVVC患者随机分为2组,试验1组进行糖代谢调整及抗真菌等综合治疗,试验2组仅抗真菌治疗,治愈后1年内复查HBA1c。结果:实验组HBA1c≥5%58例,占89.2%(58/65),而对照组仅5例,占8.3%(5/60),两组间差异非常显著(P<0.001)。实验组HBA1c、体重指数、空腹血糖均高于对照组,两组间差异非常显著(P<0.001);餐后2h血糖实验组较对照组高,但两组间无显著性差异(P>0.05)。HBA1c≥5%的RVVC患者治愈后1年内的复发率,试验1组2例复发(6.7%),试验2组有14例复发(48.28%),两组间差异显著(P<0.01);1年后试验1组与2组HBA1c≥5%的分别为3例(10.3%)与24例(82.8%),两组间差异非常显著(P<0.001)。结论:复发性外阴阴道假丝酵母菌病的非糖尿病患者,存在糖代谢异常。对复发性外阴阴道假丝酵母菌病的患者进行HBA1c检测对指导临床治疗有一定的价值。
Objective: To investigate the value of conventional HBA1c in the treatment of recurrent vulvovaginal candidiasis (RVVC). Methods: Sixty-five patients who meet the diagnostic criteria of RVVC were selected as the experimental group and the control group of 60 as mycological negative healthy volunteers and patients with recurrent bacterial vaginosis (RBV). All patients underwent fasting and postprandial blood glucose 2h , Blood HBA1c detection and calculation of body mass index. 58 patients with HBA1c≥5% were randomly divided into two groups. The first group was treated with glycometabolism and antifungal therapy. The second group was antifungal therapy only, and HBA1c was rechecked within one year after the cure. Results: In the experimental group, 58 cases (58.2%) had HBA1c≥5%, while only 5 cases (8.3%) in the control group. The difference between the two groups was significant (P <0.001). The levels of HBA1c, body mass index and fasting blood glucose of the experimental group were higher than those of the control group, with significant difference between the two groups (P <0.001). The experimental group of blood glucose 2h after meal was higher than the control group, but there was no significant difference between the two groups ). The recurrence rate within 1 year after treatment in RVVC patients with HBA1c≥5%, recurrence in 2 cases (6.7%) in trial 1 group and relapse (48.28%) in trial 2 group were significant (P <0.01); 1 Three years later (10.3%) and 24 cases (82.8%) of the HBA1c≥5% in group 1 and group 2 after the experiment, the differences between the two groups were significant (P <0.001). Conclusion: Non-diabetic patients with recurrent vulvovaginal candidiasis have abnormal glucose metabolism. The detection of HBA1c in patients with recurrent vulvovaginal candidiasis has some value in guiding the clinical treatment.