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目的:研究人型支原体共生对甲硝唑治疗阴道毛滴虫感染患者临床效果的影响。方法:分离培养阴道毛滴虫并检测其甲硝唑最小致死浓度(MLC)。PCR检测滴虫细胞内人型支原体DNA,比较共生阴道毛滴虫株在人型支原体清除前后甲硝唑MLC的变化。将患者分为阴道毛滴虫单独感染组(滴虫组)与人型支原体共生感染组(共生组),比较甲硝唑对滴虫组与共生组患者进行标准治疗后的临床治疗效果。结果:(1)200株阴道毛滴虫的甲硝唑MLC为0.2～200μg/ml,其中132株(66.0%)低MLC虫株(≤6.3μg/ml)、45株(22.5%)中MLC虫株(12.5～25μg/ml)、23株(11.5%)高MLC虫株(50～200μg/ml);(2)76株(38.0%)阴道毛滴虫检出人型支原体共生,其中低、中、高MLC虫株共生率分别为12.9%(17/132)、84.4%(38/45)和91.3%(21/23),差异有统计学意义(P<0.01);(3)200例患者甲硝唑治疗的总有效率为82.0%,其中滴虫组与共生组总有效率分别为95.2%和60.5%,差异有统计学意义(P<0.01);低、中、高MLC共生组总有效率分别为76.5%、65.8%和38.1%,差异有统计学意义(P<0.05);(4)11株共生虫株经多西环素作用清除人型支原体后,其甲硝唑MLC基本无变化。结论:人型支原体共生可能与甲硝唑治疗阴道毛滴虫的临床效果有关,但未发现直接相关关系。
Objective: To study the effect of Mycoplasma hominis symbiosis on clinical efficacy of metronidazole in the treatment of Trichomonas vaginalis infection. Methods: Trichomonas vaginalis was isolated and cultured, and the minimum lethal concentration (MLC) of metronidazole was measured. PCR was used to detect the Mycoplasma hominis DNA in the cells of Trichomonas and the changes of metronidazole MLC before and after removal of Mycoplasma hominis were compared. The patients were divided into Trichomonas vaginalis infection group (Trichomonas group) and Mycoplasma hominis symbiotic infection group (Symbiosis group). The clinical effect of metronidazole on the treatment of Trichomonas group and symbiosis group was compared. Results: (1) The metronidazole MLC of 200 strains of Trichomonas vaginalis were 0.2 ~ 200μg / ml, of which 132 strains (66.0%) had low MLC (≤6.3μg / ml) and 45 23 strains (11.5%) of MLC strains (50 ~ 200μg / ml); (2) 76 strains (38.0%) of Trichomonas vaginalis detection of Mycoplasma hominis, in which low . The symbiotic rates of mid and high MLC strains were 12.9% (17/132), 84.4% (38/45) and 91.3% (21/23), respectively, with statistical significance (P <0.01) The total effective rate of metronidazole in patients was 82.0%. The total effective rates of trichomoniasis group and symbiotic group were 95.2% and 60.5%, respectively, with significant difference (P <0.01); low, medium and high MLC The total effective rate was 76.5%, 65.8% and 38.1%, respectively, with statistical significance (P <0.05). (4) After 11 strains of symbiotic strains were treated with doxycycline to eliminate Mycoplasma hominis, MLC basically no change. Conclusion: Mycoplasma hominis may be related to the clinical efficacy of metronidazole in the treatment of Trichomonas vaginalis, but no direct correlation was found.