阴道毛滴虫与人型支原体共生关系及其临床研究(1)
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[摘要] 目的:探讨阴道毛滴虫与人型支原体的共生关系以及共生关系的临床耐药性,以选择更合适的治疗药物。方法:随机对262例诊断为滴虫阴道炎患者及73例生殖道人型支原体感染患者给予常规药物治疗,并对滴虫阴道炎患者进行人型支原体检测。结果:滴虫阴道炎合并人型支原体感染者238例(90.8%)。经药物治疗后,筛选出可能存在阴道毛滴虫与人型支原体共生关系的难治性阴道炎68例患者。结论:阴道毛滴虫与人型支原体存在共生关系,且临床治疗效果较单纯感染治疗效果差。如何更好地治疗难治性滴虫阴道炎,有待进一步研究。
[关键词] 阴道毛滴虫;人型支原体;共生关系
[中图分类号] R711[文献标识码]A [文章编号]1673-7210(2010)06(c)-050-02
Symbiotic relationship and clinical research of Trichomonas vaginalis and Mycoplasma hominis
LIU Shaoping1, LUO Cuilian2, CHEN Yihong2
(1.People and Family Planning Service Station in Huadu District of Guangzhou City, Guangzhou 510800, China; 2.The Maternal and Child Health Hospital in Yuexiu District of Guangzhou City, Guangzhou510030, China)
[Abstract] Objective: To explore the symbiotic relationship between Trichomonas vaginalis and Mycoplasma hominis and the clinical drug resistance of the symbionts. Methods: The routine drug treatment was used for 262 cases of patients with Trichomonas vaginalitis and 73 cases of patients with Mycoplasma hominis infection. Then to detect Mycoplasma hominis in patients with Trichomonas vaginitis. Results: It was shown that Trichomonas vaginitis combined Mycoplasma hominis infection were 238 cases (90.8%). After drug treatment, screened out 68 refractory vaginitis patients with Trichomonas vaginalis and Mycoplasma hominis. Conclusion: Symbiotic relationship of Trichomonas vaginalis and Mycoplasma hominis exists, and the therapeutic effects are worse than a single infection. It needs further study to treat refractory Trichomonas vaginitis.
[Key words] Trichomonas vaginalis; Mycoplasma hominis; Symbiotic relationship
阴道毛滴虫与人型支原体均是常见的寄生于人体泌尿生殖道的病原体,两者均可导致生殖道炎症,体外实验证实两者成共生关系并产生耐药性,去除共生的支原体后,毛滴虫的耐药性大大减低[1],但临床上体内的阴道毛滴虫与人型支原体共生是否造成阴道毛滴虫病难以治疗国内外相关报道较少。本研究借助分子生物学技术,通过研究体外阴道毛滴虫与人型支原体共生关系并结合临床,从而探讨临床上体内的阴道毛滴虫与人型支原体的共生是否造成难治性阴道毛滴虫病,开拓临床诊疗的新思路。
1 资料与方法
1.1 一般资料
2008年10月～2009年10月本课题组随机收治滴虫阴道炎患者262例,并对其进行人型支原体检测,人型支原体感染患者73例;年龄最小17岁,最大45岁,平均29.6岁。患者均有性生活史,临床症状及体征主要为白带增多、有腥臭味、性交后加重,并有不同程度的外阴瘙痒,阴道黏膜或子宫颈充血、红肿。
1.2 方法
1.2.1 临床诊断方法滴虫阴道炎检查:取分泌物前24～48 h避免性生活、阴道灌洗或局部用药,窥阴器不涂润滑剂,患者经妇科医生用窥阴器暴露阴道及宫颈,直接观察阴道黏膜是否有充血,并观察阴道分泌物的性状。用无菌棉拭子在阴道后穹隆处采集分泌物,分泌物取出后及时送检并注意保暖,否则滴虫活动力减弱,造成辨认困难 ......
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