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摘要: 细菌性阴道炎(bacterial vaginosis，BV)是由阴道内正常产生过氧化氢的乳杆菌减少、厌氧菌(动弯杆菌、普雷沃氏菌)和兼性厌氧菌(阴道加德纳菌、阴道阿托波菌)过度繁殖导致的阴道微生态平衡失调，表现为混合感染。BV不仅与盆腔炎、不孕症、性传播病原体(人乳头瘤病毒、人类免疫缺陷病毒、淋病奈瑟菌、沙眼衣原体等)感染风险增加相关，妊娠期合并BV还可能导致早期流产、早产、产后子宫内膜炎和新生儿低出生体重等不良妊娠结局。导致BV的病原体多样，且经治疗后复发率高。约10%~50%的BV患者无临床症状，易漏诊，而快速、准确的实验室检测能够对BV患者进行及时诊断和治疗、避免不良结局的发生。本文就BV的诊断标准、阴道微生态评价以及新型检测方法等研究进展作一综述，以期为BV的临床诊断和治疗提供借鉴和参考。Abstract: Bacterial vaginosis (BV), an imbalance of normal vaginal microecology, is manifested as a mixed infection. It is characterized by a decrease of normal hydrogen peroxide-producing lactobacillus and an overgrowth of anaerobic bacteria (mobiluncus, prevotella) and facultative bacteria (gardnerella vaginalis, atopo vaginalis). BV is a risk factor for pelvic inflammatory disease, infertility, sexually transmitted pathogens (human papillomavirus, human immunodeficiency virus, neisseria gonorrhoeae, chlamydia trachomatis, etc.) infection. In addition, BV during pregnancy can lead to adverse obstetrical outcomes, including early miscarriage, premature delivery, postpartum endometritis, and low birth weight. The pathogens causing BV are diverse and have a high recurrence rate after treatment. About 10% to 50% of BV patients have no clinical symptoms and are easy to miss diagnosis. Rapid and accurate laboratory detection can provide timely diagnosis and treatment for BV patients and avoid adverse outcomes. Therefore, this paper reviews the research progress of diagnostic criteria, vaginal microecological evaluation and novel detection methods for BV, in order to provide reference for clinical diagnosis and treatment of BV.
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Key words:
- bacterial vaginosis /
- laboratory diagnosis /
- vaginal microbiome
作者贡献：王喆负责文献查阅、论文撰写；赵颖、徐英春负责论文审校。利益冲突：所有作者均声明不存在利益冲突 -
表 1 Nugent评分标准
评分 乳杆菌平均数量 加德纳菌及普雷沃氏菌平均数量 动弯杆菌平均数量 0 4+ - - 1 3+ 1+ 1+或2+ 2 2+ 2+ 3+或4+ 3 1+ 3+ - 4 - 4+ - 1+：平均细菌数量≥1个；2+：平均细菌数量为2~4个；3+：平均细菌数量为5~30个；4+：平均细菌数量＞30个 
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