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目的探讨妊娠期糖尿病(GDM)孕妇阴道微生态变化特征。方法随机选取2011年11月—2013年1月正常产检的GDM孕妇256例为实验组,另选取同期产检正常孕妇221例和正常妇科体检妇女198例为对照组,对两组行阴道分泌物涂片Nugent评分及阴道菌群检查,进行微生态评价。结果阴道pH值在GDM、正常妊娠及体检组分别为(3.46±0.23)、(3.62±0.20)及(4.22±0.34),妊娠组低于非孕组,差异显著(P﹤0.01);乳杆菌检出率分别为91.1%、87.5%及77.8%,妊娠组高于正常体检组(P﹤0.05);外阴阴道假丝酵母菌病(VVC)检出率分别为33.6%、22.5%及18.2%,GDM组高于对照组(P﹤0.05);细菌性阴道病(BV)发生率11.1%、13.2%及34.0%,GDM组与正常妊娠组比较无差异(P﹥0.05),但妊娠组低于正常体检组(P﹤0.01)。结论 GDM孕妇阴道微生态发生改变,应积极控制血糖水平,防治不良妊娠结局。
Objective To investigate the vaginal microecological changes in pregnant women with gestational diabetes mellitus (GDM). Methods Totally 256 GDM pregnant women, who were randomly selected from November 2011 to January 2013, were selected as the experimental group. 221 pregnant women and 198 women with normal gynecological examination were selected as the control group. The vaginal discharge Nugent score and vaginal flora inspection, microecological evaluation. Results The vaginal pH values in the GDM group, normal pregnancy group and the physical examination group were (3.46 ± 0.23), (3.62 ± 0.20) and (4.22 ± 0.34), respectively, and those in the pregnancy group were significantly lower than those in the non-pregnant group (P <0.01) The detection rates of vulvovaginal candidiasis (VVC) were 33.6%, 22.5% and 18.2% respectively in the pregnant group (91.1%, 87.5% and 77.8%, respectively) (P <0.05). The incidence of bacterial vaginosis (BV) was 11.1%, 13.2% and 34.0% respectively in GDM group. There was no significant difference between GDM group and normal pregnancy group (P> 0.05) In the normal group (P <0.01). Conclusion GDM vaginal changes in vaginal ecology, should actively control blood sugar levels, prevention and treatment of adverse pregnancy outcomes.