Natural history of asymptomatic bacterial vaginosis and the risk factors for its outcome

目的：：研究无症状性细菌性阴道病( BV)患者的自然转归情况,分析可能影响自然转归的高危因素。方法：从体检中心选取未治疗的无症状性BV患者160例,跟踪观察4个月,记录每例患者的病例特点及最终结局。单变量分析及多变量分析各种因素与结局之间的相关性。结果：160例患者中,41％病情进展,53％病情无明显变化,6％病情自行好转。病情进展的患者中,38％变为有症状的BV,24％变为BV合并VVC。单变量分析发现,经常出差( OR 3.72,95%CI 1.85~7.46)、BV病史( OR 4.78,95%CI 2.42~9.44)与患者病情进展有关。安全套避孕( OR=0.46,95%CI 0.24~0.90)、Nugent评分较低( OR=0.40,95%CI 0.21~0.79)对无症状BV有保护作用。多变量分析发现,安全套避孕对患者有保护作用,BV病史和经常出差是病情进展的高危因素。结论：对无症状性BV患者进行干预是必要的。Objective:To evaluate the natural history of asymptomatic bacterial vagino-sis and analyze the risk factors which may affect the outcome. Methods:Volunteer women who were diagnosed as asymptomatic bacterial vaginosis and refused to accept treatment were recrui-ted for this study. During the four months, the characteristics of all the women were recorded and the outcomes of the disease were assessed in the end of four months. Univariate analysis and multivariate analysis were used to analyze the risk factors. Results:160 volunteer women were recruited in the study. In the end of four months,41% of the patients became more serious than before. 53% of the patient were stable,and only 6% of them became spontaneous healing. In the patients who became more serious than before,38% became symptomatic BV and others be-came mixed infection. Univariate analysis indicated that always travelling ( OR 3. 72,95%CI 1. 85~7. 46),and history of BV (OR 4. 78,95%CI 2. 42~9. 44) were related to the progress of the disease. Use of condom (OR 0. 46,95%CI 0. 24~0. 90) and lower Nugent score (OR 0. 40,95%CI 0. 21~0. 79) were beneficial to the patients. Multivariate analysis found that his-tory of BV and always travelling were high risk factor for the progress of the disease,and use of condom was beneficial to patients. Conclusions:It was necessary to manage these asymptomatic bacterial vaginosis.国家自然科学基金资助项目中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)12881-8842