三种常见阴道分泌物念珠菌检测手段的方法学评价
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[摘要] 目的 评价三种白带念珠菌检测手段的方法学差异。方法 对540例拟诊为念珠菌阴道炎患者的分泌物同时做盐水涂片、快速染色镜检和真菌培养。结果 盐水涂片法念珠菌阳性率为60.4%，染色法和培养法阳性率分别为75.8%、78.9%。盐水涂片法操作简单、快捷、阳性率较低，与染色法和培养法阳性率差异有统计学意义(P<0.01)；后两者阳性率较高，差异无统计学意义(P>0.05)。结论 相比较，培养法能做鉴定和药敏，能指导临床用药，缺点是需要特殊仪器和试剂、操作繁琐、耗时长，不利于念珠菌阴道炎的早期诊断和治疗；染色镜检法操作简单、快速，有利于早期诊断，但不能指导临床用药。
[关键词] 阴道分泌物；念珠菌；阴道炎
[中图分类号] R711.3 [文献标识码] B [文章编号] 1673-9701(2011)26-89-02
Appraisal of Three Common Means of Examination of Common Vagina Secretion Monilia
WANG Hong XU Meng
Clinical Laboratory of First People's Hospital of Xinyang City in Henan Province， Xinyang 464000，China
[Abstract] Objective To evaluated three kinds of vaginal candidiasis methodological differences in testing methods. Methods All 540 patient's clinically diagnosed as of candida vaginitis discharge while doing salt water smear，the microscope after rapid dyeing and the fungus culture. Results Positive rate of Monilia was 60.4% demonstrated by the salt water smear；75.8% positive rate by the method of rapid dyeing microscope，78.9% positive rate by the method of fungus culture. There was significant difference in the positive rate between salt water smear，the microscope after rapid dyeing and the fungus culture(P<0.01)；The positive rate of the microscope after rapid dyeing and the fungus culture were higher，but there were no significant difference between them(P>0.05). Conclusion In Comparison，the identification of Monilia and medicine sensitive examination can be effectively demonstrated by fungus culture method，which is helpful to instruct the clinical medication but with several shortcomings like special instrument and reagent are indispensable；complex operation；long time-consuming，these impede early diagnosis of the vagina secretion Monilia and treatment. Relative Simplicity of operation enables rapid dyeing microscopic exam method to obtain early diagnosis，but untenable instruct the clinical medication.
[Key words] Vaginal secretion；Monilia；Vaginitis
念珠菌阴道炎是临床常见的妇科疾病，近年来随着广谱抗生素的广泛使用，念珠菌耐药问题也日趋严重，念珠菌阴道炎已成为妇科门诊的常见病和重要问题。本文对阴道分泌物常见的三种检测手段(盐水涂片法、快速染色镜检法、培养法)进行方法学比较分析，现将结果报道如下。
1 材料与方法
1.1 标本来源
选择本院2009年6月～2010年12月妇科门诊拟诊为念珠菌阴道炎患者的分泌物标本540份，性状：豆腐渣样、凝乳状、颗粒样，干燥，患者年龄20～71岁。
1.2 试剂和仪器
妇科多功能染液(株洲康乐检测试剂有限公司)、沙保弱培养基(郑州博赛科技有限公司)、真菌鉴定及药敏分析系统(法国生物-梅里埃公司)。
1.3 方法
用无菌棉拭子取三支阴道分泌物，一支用作盐水涂片，一支用作染色镜检，一支用作35℃真菌培养。盐水涂片法：将标本置于0.2mL生理盐水中充分混匀，高倍镜镜检；快速染色法：制成厚薄合适、均匀的涂片，干燥后用快速染色，油镜镜检；真菌培养法：将分泌物接种于沙保弱培养基，35℃培养，若出现酵母样菌落，经革兰染色证实为真菌后，种于法国生物-梅里埃公司提供的API32C念珠菌鉴定板及ATB真菌药敏板，35℃培养，在ATB Expression全自动微生物鉴定仪上判读结果。
1.4 统计学处理
对数据行χ2检验，P<0.05为差异有统计学意义。
2 结果 ......
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