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目的:分析外阴阴道假丝酵母菌病(VVC)疾病严重程度的相关影响因素。方法:将2011年8月~2015年8月就诊于天津医科大学总医院普通妇科门诊的237例重度VVC患者及同期490例轻中度VVC患者作为研究对象进行病例对照研究。采用Logistic回归模型进行单因素及多因素分析。结果:(1)单因素分析显示,年龄≥30岁(OR=0.658,95%CI为0.481~0.899,P=0.009)、已婚(OR=0.560,95%CI为0.394~0.794,P=0.001)、采用自然避孕法避孕(OR=0.588,95%CI为0.359~0.965,P=0.036)、有妊娠史(OR=0.565,95%CI为0.411~0.777,P=0.000)、有阴道分娩史(OR=0.557,95%CI为0.371~0.835,P=0.005)是重度VVC的保护因素。白假丝酵母菌感染(OR=5.678,95%CI为2.180~14.789,P=0.000)是重度VVC的危险因素。对食物、药物或花草过敏(OR=1.713,95%CI为0.982~2.988,P=0.058)是重度VVC的可疑危险因素。(2)多因素分析显示,白假丝酵母菌感染(OR=4.593,95%CI为1.700~12.414,P=0.003)以及对药物、食物或花草过敏(OR=2.172,95%CI为1.059~4.458,P=0.034)是重度VVC的独立危险因素。结论:白假丝酵母菌感染以及对药物、食物或花草过敏是重度VVC的独立危险因素。
Objective: To analyze the influencing factors of severity of vulvovaginal candidiasis (VVC) disease. Methods: From August 2011 to August 2015, 237 patients with severe VVC and 490 mild-to-moderate VVC patients attending the general gynecological clinic of Tianjin Medical University General Hospital were selected as the case-control study. Logistic regression model was used for univariate and multivariate analysis. Results: (1) Univariate analysis showed that the patients who were aged ≥30 years (OR = 0.658, 95% CI 0.481-0.899, P = 0.009) were married (OR = 0.560,95% CI 0.394-0.794, P = 0.001 (OR = 0.588, 95% CI: 0.359-0.965, P = 0.036), pregnancy history (OR = 0.565, 95% CI: 0.411-0.777, P = 0.000) and vaginal delivery history (OR = 0.557, 95% CI 0.371-0.835, P = 0.005) was a protective factor for severe VVC. Candida albicans infection (OR = 5.678, 95% CI 2.180 to 14.789, P = 0.000) was a risk factor for severe VVC. Allergy to food, medicine or flowers (OR = 1.713, 95% CI 0.982-2.988, P = 0.058) was a suspicious risk factor for severe VVC. (2) Multivariate analysis showed that Candida albicans infection (OR = 4.593, 95% CI 1.700-12.414, P = 0.003) and allergy to drugs, food or flowers (OR = 2.172, 95% CI 1.059 ~ 4.458, P = 0.034) were independent risk factors for severe VVC. Conclusion: Candida albicans infection and allergy to drugs, food or flowers are independent risk factors for severe VVC.