多囊卵巢综合征患者与健康妇女阴道微生态临床特点对比研究

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目的 对比多囊卵巢综合征(PCOS)患者与健康妇女阴道微生态指标,为PCOS患者发病机制的认知提供参考,并为治疗PCOS开拓新的思路.方法 选择柳州市妇幼保健院2017年收治的200例PCOS患者作为研究组,选择同期在该院行健康体检的200例健康育龄女性作为对照组.两组均于月经干净3~7 d后采集阴道分泌物,检测pH值、菌群密集度、菌群多样性、优势菌、清洁度、滴虫、假丝酵母菌及乳酸杆菌情况.比较两组上述阴道微生态指标,分析两组阴道微生态是否失调.结果 两组患者年龄比较差异无统计学意义(P>0.05).研究组患者阴道微生态失调率、滴虫检出率及假丝酵母菌检出率、清洁度(Ⅲ+Ⅳ)率均明显高于对照组(P<0.05).两组受试者pH值、菌群密集度、菌群多样性、优势菌及乳酸杆菌比较差异均无统计学意义(均P>0.05).结论 POCS患者阴道微生态状况部分指标差于健康妇女,可能与激素水平的差异关系密切,调整PCOS患者的阴道微生态状况,可能是治疗PCOS的一种新途径,进一步完善PCOS患者与健康妇女激素水平、胰岛素抵抗及雄性激素指标的关系研究,对进一步解读PCOS发病机制有所帮助.“,”Objective To compare the vaginal microecological indicators between the patients with polycystic ovary syndrome (PCOS) and healthy women, provide a reference for cognition of PCOS pathogenesis in these patients, and find new ideas for treatment of PCOS. Methods A total of 200 patients with PCOS treated in Liuzhou Maternal and Child Health Care Hospital in 2017 were selected as study group, and 200 healthy women of childbearing age receiving healthy physical examination in the hospital during the same period were selected as control group. Vaginal secretion samples were obtained durinng 3-7 days after the end of last menstruation in the two groups. pH values, bacterial densities, microbial diversities, dominant bacteria, cleanliness, trichomonas, Candida, and lactobacillus were detected in the two groups. The vaginal microecological indicators in the two groups were compared. The vaginal microecological balance situations in the two groups were analyzed. Results There was no statistically significant difference in age between the two groups (P>0.05). The incidence rate of vaginal microecological imbalance, the detection rates of trichomonas and Candida, the proportion of women with cleanliness Ⅲ and Ⅳ in study group were statistically significantly higher than those in control group (P<0.05). There was no statistically significant difference in pH value, bacterial density, microbial diversity, dominant bacteria, and Lactobacillus between the two groups (P>0.05). Conclusion Partial vaginal microecological indicators in POCS patients are poorer compared with healthy women, which may be closely correlated with the levels of hormones. Adjusting vaginal microecosystem may be a new way for treatment of PCOS. Further improving the studies about the relationships among levels of hormones, insulin resistance, and androgen in PCOS patients and healthy women can further confirm the pathogenesis of PCOS.
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