标题：需氧菌性阴道炎的病因、诊断及治疗进展

      作者：程薇 综述 周新娥 审校    成都市妇女儿童中心医院妇产科，四川 成都 610031

      卷次： 2020年31卷4期

      【摘要】 需氧菌性阴道炎(aerobic vaginitis，AV)是一种在2002年才被正式认识并命名的阴道感染。它的特征是阴道分泌物中存在异常的阴道菌群，含有需氧菌、肠道细菌、阴道炎症程度不一和阴道上皮成熟不足。AV易与其他阴道疾病共同发生，如BV (bacterial vaginosis)和阴道念珠菌病(vulvovaginal candidiasis)。它可能与性交困难、性传播感染(如人乳头状瘤病毒、人类免疫缺陷病毒、阴道毛滴虫和沙眼衣原体)、绒毛膜羊膜炎、胎儿感染、早产有关。AV的诊断方式目前多数采用的Donders 阴道分泌物显微镜湿片评分，最理想的是使用相差显微镜。它的评分依据是：乳酸菌等级、炎症的存在、毒性白细胞的比例、微生态特征和未成熟上皮细胞的存在。对于AV的最佳治疗方案目前尚未完全确定，治疗方案必须根据显微镜检查结果和患者的需要进行调整。研究认为局部雌激素治疗、皮质类固醇、抗菌药和益生菌都有作用。更精确的诊断、发病机制、管理和预防方式还期待进一步的研究。
      【关键词】 需氧菌性阴道炎；细菌性阴道病；阴道微生态；Donders 阴道分泌物显微镜湿片
      【中图分类号】 R711.31 【文献标识码】 A 【文章编号】 1003—6350（2020）04—0523—06

Advances in etiology, diagnosis and treatment of aerobic vaginitis.
CHENG Wei，ZHOU Xin-e. Chengdu Women's andChildren's Central Hospital, Chengdu 610031, Sichuan, CHINA【Abstract】 Aerobic vaginitis (AV) is a kind of vaginal infection that was officially recognized and named in2002. It is characterized by the presence of abnormal vaginal flora in vaginal secretions, including aerobic bacteria, intes-tinal bacteria, vaginitis of varying degrees, and vaginal epithelial maturation. AV is easy to occur together with other vag-inal diseases, such as bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC). It may be related to sexual difficul-ties, sexually transmitted infections (such as human papillomavirus, human immunodeficiency virus, Trichomonas vagi-nalis and Chlamydia trachomatis), chorioamnionitis, fetal infection, and preterm delivery. At present, most of the diagno-sis methods of AV are based on the Donders vaginal discharge microscopy wet film score, and the best one is to use thephase contrast microscopy (PCM). It was scored on the basis of Lactobacillus grade, the presence of inflammation, theproportion of toxic leukocytes, microecological characteristics, and the presence of immature epithelial cells. At present,the best treatment plan for AV has not been fully determined, but the treatment plan must be adjusted according to the re-sults of microscopy and the needs of patients. Local estrogen therapy, corticosteroids, antibiotics and probiotics are all ef-fective. More accurate diagnosis, pathogenesis, management, and prevention methods are expected to be further studied.
      【Key words】 Aerobic vaginitis (AV); Bacterial vaginosis (BV); Vaginal microecology; Donders vaginal secretionmicroscopy wet film·综述·doi:10.3969/j.issn.1003-6350.2020.04.031