细菌性阴道病:修订间差异

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{{Infobox disease
{{Infobox medical condition
| Name = 细菌性阴道炎
| Name = 细菌性阴道炎
| Image = Vaginose-G15.jpg
| Image = Vaginose-G15.jpg
| Caption = 显微镜下的细菌性阴道炎中出现的{{le|阴道加德菌|Gardnerella vaginalis}}
| Caption = 显微镜下的细菌性阴道炎,圖{{le|阴道加德菌|Gardnerella vaginalis}}和子宮頸的鱗狀上皮細胞
| field = [[婦科學]], {{tsl|en|Infectious disease (medical specialty)||infectious disease}}
| synonyms = anerobic vaginositis、非特異性陰道炎(Nonspecific vaginitis)、vaginal bacteriosis、Gardnerella vaginitis<ref name=History1997>{{cite book|last1=Borchardt|first1=Kenneth A.|title=Sexually transmitted diseases : epidemiology, pathology, diagnosis, and treatment|date=1997|publisher=CRC Press|location=Boca Raton [u.a.]|isbn=9780849394768|pages=4|url=https://books.google.ca/books?id=k_9sjs-n0nIC&pg=PA4}}</ref>
| DiseasesDB =
| DiseasesDB =
| ICD10 = {{ICD10|B|96||b|95}}, {{ICD10|N|76||n|70}}
| ICD10 = {{ICD10|B|96||b|95}}{{ICD10|N|76||n|70}}
| ICD9 = {{ICD9|616.1}}
| ICD9 = {{ICD9|616.1}}
| ICDO =
| ICDO =
第13行: 第15行:
| MeshID = D016585
| MeshID = D016585
}}
}}
'''细菌性阴道炎'''、'''细菌性阴道病'''({{lang|en|Bacterial vaginosis}}),也称'''非特异性阴道炎'''({{lang-en|Nonspecific vaginitis}}),是一种因细菌引起的阴道疾病<ref>{{cite web |url=http://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm |title=Bacterial Vaginosis – CDC Fact Sheet |author= |date=1 September 2010 |work= |publisher=[[Centers for Disease Control and Prevention]] |accessdate=11 November 2011}}</ref><ref name=GCH>{{cite web |url=http://www.guideline.gov/summary/summary.aspx?doc_id=11602 |title=National guideline for the management of bacterial vaginosis (2006) |work=Clinical Effectieness Group, British Association for Sexual Health and HIV (BASHH) }}</ref>。细菌性阴道炎通常与性交传染有关,它经常与[[酵母菌感染]]或[[滴虫性阴道炎]]混淆,后两者并非细菌引起<ref>{{cite web|url=http://women.webmd.com/features/is-it-yeast-infection |author=Terri Warren, RN |title=Is It a Yeast Infection? |year=2010 |accessdate=23 February 2011}}</ref><ref>{{cite journal |doi=10.1016/S0029-7844(01)01759-8 |author=Ferris DG, Nyirjesy P, Sobel JD, Soper D, Pavletic A, Litaker MS |date=March 2002 |title=Over-the-counter antifungal drug misuse associated with patient-diagnosed vulvovaginal candidiasis |journal=Obstetrics and Gynecology |volume=99 |issue=3 |pages=419–425 |pmid=11864668 }}</ref>。



常见的病原菌有[[葡萄球菌]]、[[链球菌]]、[[大肠杆菌]]及[[变形杆菌]]等。主要症状有局部下坠及灼热感,或盆腔不适感。[[阴道分泌物]]增多并呈脓状或浆液状,严重情况还会出现[[尿频]]、尿急等。分泌物涂片行[[革兰染色检查]]可发现常见细菌<ref name = Amsel>{{cite journal |author=Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK |title=Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations |journal=Am. J. Med. |volume=74 |issue=1 |pages=14–22 |year=1983 |pmid=6600371 |doi=10.1016/0002-9343(83)91112-9 }}</ref><ref>{{cite journal|author=沙玉成, 马丽|title=细菌性阴道病的诊断与治疗进展|journal=中国实用妇科与产科杂志|year=2005|volume=21|issue=3|pages=131-133|url=http://www.cqvip.com/qk/90644a/200503/15018962.html|accessdate=2014-08-23}}</ref>。


<!-- Definition and symptoms -->

'''細菌性陰道炎'''({{lang|en|Bacterial vaginosis}},簡稱'''BV'''),又稱'''細菌性陰道病'''、'''非特異性陰道炎'''(Nonspecific vaginitis)是種發生在[[陰道]]內的[[疾病]],其原因是[[細菌]]大量滋生而造成的<ref name=Don2014/><ref name="ClarkTal2014">{{cite journal|last1=Clark|first1=Natalie|last2=Tal|first2=Reshef|last3=Sharma|first3=Harsha|last4=Segars|first4=James|title=Microbiota and Pelvic Inflammatory Disease|journal=Seminars in Reproductive Medicine|volume=32|issue=01|year=2014|pages=043–049|issn=1526-8004|doi=10.1055/s-0033-1361822|pmid=24390920|pmc=4148456}}</ref>。常見的症狀包括有[[陰道分泌物]]增加,而且分泌物有魚腥味<!-- <ref name=NIH2013S/> -->,且色澤多為白或灰色<!-- <ref name=NIH2013S/> -->。有時排尿時也會伴隨產生[[灼熱感]]<ref name=NIH2013S/>。搔癢則較不常見<ref name=Don2014/><ref name=NIH2013S/>,某些時候甚至可能完全沒有任何病徵出現<ref name=NIH2013S>{{cite web|title=What are the symptoms of bacterial vaginosis?|url=http://www.nichd.nih.gov/health/topics/bacterialvag/conditioninfo/Pages/symptoms.aspx|accessdate=3 March 2015|date=2013-05-21}}</ref>。在感染細菌性陰道炎的情況下,另外感染其他[[性傳染病]]的機率大約提昇了一倍之多,而這當中包含了愛滋病(AIDS)<ref name=Ken2013>{{cite journal|last1=Kenyon|first1=C|last2=Colebunders|first2=R|last3=Crucitti|first3=T|title=The global epidemiology of bacterial vaginosis: a systematic review.|journal=American Journal of Obstetrics and Gynecology|date=December 2013|volume=209|issue=6|pages=505–23|pmid=23659989|doi=10.1016/j.ajog.2013.05.006}}</ref><ref name=Bradshaw2015>{{cite journal|last1=Bradshaw|first1=CS|last2=Brotman|first2=RM|title=Making inroads into improving treatment of bacterial vaginosis - striving for long-term cure|journal=BMC Infectious Diseases|date=July 2015|volume=15|issue=|pages=292|pmid=26219949|pmc=4518586|doi=10.1186/s12879-015-1027-4}}</ref>。此疾病也連帶提高了產婦[[早產]]的機率<ref name=Queenan2012>{{cite book|last1=Queena|first1=John T. .|last2=Spong|first2=Catherine Y|last3=Lockwood|first3=Charles J., editors|title=Queenan's management of high-risk pregnancy : an evidence-based approach|page=262|date=2012|publisher=Wiley-Blackwell|location=Chichester, West Sussex|isbn=9780470655764|edition=6th}}</ref><ref>{{cite web|title=What are the treatments for bacterial vaginosis (BV)?|url=http://www.nichd.nih.gov/health/topics/bacterialvag/conditioninfo/Pages/treatments.aspx|publisher=National Institute of Child Health and Human Development|accessdate=4 March 2015|date=2013-07-15}}</ref>。

<!-- Cause and diagnosis -->
細菌性陰道炎和存在於陰道內的原生細菌失衡有關<ref name=Bennett2015>{{cite book | last = Bennett | first = John | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 9781455748013}}</ref><ref name=NIH2013O/>。原先在陰道內常見的細菌發生了改變,且現有細菌數量以數百甚至數千倍的增加<ref name=Don2014/>。除了[[乳酸桿菌]]外,多了非常多其他的細菌<ref name=Nardis2013>{{cite journal|last1=Nardis|first1=C.|last2=Mastromarino|first2=P.|last3=Mosca|first3=L.|title=Vaginal microbiota and viral sexually transmitted diseases|journal=Annali di Igiene |date=September–October 2013 |volume=25|issue=5|pages=443–56|doi=10.7416/ai.2013.1946|pmid=24048183}}</ref>。危險因子包括{{tsl|en|douching||沖洗陰道}}、新交或多重新伴侶、[[抗细菌药|抗生素]]還有使用[[子宮環]]等<ref name=NIH2013O/>。但不管怎麼說,細菌性陰道炎並不屬於性傳染病的一種<ref name="cdc.gov">{{cite web |url=http://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm |title=Bacterial Vaginosis – CDC Fact Sheet |author= |date=March 11, 2014 |publisher=[[美国疾病控制与预防中心]] |accessdate=2 Mar 2015}}</ref>。診斷會建立在已有病症的情況下,接著檢測陰道分泌物再了解陰道內的[[pH值]]是否較正常為高,以及細菌數有無異常<ref name=Don2014/>。細菌性陰道炎常會和[[念珠菌性外阴阴道炎]]或是[[滴虫性阴道炎]]混淆<ref>{{cite journal|last1=Mashburn|first1=J|title=Etiology, diagnosis, and management of vaginitis.|journal=Journal of midwifery & women's health|date=2006|volume=51|issue=6|pages=423–30|pmid=17081932|doi=10.1016/j.jmwh.2006.07.005}}</ref>。

<!-- Prevention and treatment -->
治療細菌性陰道炎多使用抗生素,例如[[克林黴素]]或[[甲硝唑]]<!-- <ref name=Don2014/> -->。這些藥物都可以在[[妊娠|孕期]]的第二或第三月期裡使用<!-- <ref name=Don2014/> -->但是,在治療過後又常有復發的情形<!-- <ref name=Don2014> -->。[[益生菌]]據信可幫助預防降低復發的可能性<ref name=Don2014>{{cite journal|last1=Donders|first1=GG|last2=Zodzika|first2=J|last3=Rezeberga|first3=D|title=Treatment of bacterial vaginosis: what we have and what we miss.|journal=Expert opinion on pharmacotherapy|date=April 2014|volume=15|issue=5|pages=645–57|pmid=24579850|doi=10.1517/14656566.2014.881800}}</ref>。目前還不清楚在懷孕時使用益生菌或抗生素對孕婦是否有任何影響<ref name=Don2014/><ref>{{cite journal|last1=Othman|first1=M|last2=Neilson|first2=JP|last3=Alfirevic|first3=Z|title=Probiotics for preventing preterm labour.|journal=The Cochrane database of systematic reviews|date=24 January 2007|issue=1|pages=CD005941|pmid=17253567|doi=10.1002/14651858.CD005941.pub2}}</ref>。

<!-- Epidemiology and history -->
細菌性陰道炎是育齡婦女常見的疾病<ref name=NIH2013O>{{cite web|title=Bacterial Vaginosis (BV): Condition Information|url=http://www.nichd.nih.gov/health/topics/bacterialvag/conditioninfo/Pages/default.aspx|publisher=National Institute of Child Health and Human Development|accessdate=3 March 2015|date=2013-05-21}}</ref>,在特定時間中,女性感染的比率大約介於5-70%<ref name=Ken2013/>。在非洲,女性患有此疾病的比例最高,但在亞洲與歐洲則都是相對較低的<ref name=Ken2013/>。美國的統計數據顯示,在14至49歲的女性中,罹患細菌性陰道炎的百分比約是30%<ref name=CDC2010Stats>{{cite web|title=Bacterial Vaginosis (BV) Statistics Prevalence|url=http://www.cdc.gov/std/bv/stats.htm|website=cdc.gov|accessdate=3 March 2015|date=September 14, 2010}}</ref>。在每個國家裡,不同[[種族]]的感染比率大不相同<ref name=Ken2013/>。歷史上,對於細菌性陰道炎的描述雖早已完備,但第一起有記錄在案的病例是1894年<ref name=History1997/>。


==参考==
==参考==

2016年5月3日 (二) 13:46的版本

细菌性阴道炎
同义词anerobic vaginositis、非特異性陰道炎(Nonspecific vaginitis)、vaginal bacteriosis、Gardnerella vaginitis[1]
Vaginose-G15.jpg
显微镜下的细菌性阴道炎,圖中為阴道加德菌英语Gardnerella vaginalis和子宮頸的鱗狀上皮細胞
类型陰道炎, 细菌感染疾病[*], particular disease[*]
肇因陰道加德諾菌[*]
分类和外部资源
醫學專科婦科學, infectious disease英语Infectious disease (medical specialty)
ICD-10B96N76
ICD-9-CM616.1
eMedicine254342
Patient UK英语Patient UKBacterial-Vaginosis-(BV) 细菌性阴道病
MeSHD016585



細菌性陰道炎Bacterial vaginosis,簡稱BV),又稱細菌性陰道病非特異性陰道炎(Nonspecific vaginitis)是種發生在陰道內的疾病,其原因是細菌大量滋生而造成的[2][3]。常見的症狀包括有陰道分泌物增加,而且分泌物有魚腥味,且色澤多為白或灰色。有時排尿時也會伴隨產生灼熱感[4]。搔癢則較不常見[2][4],某些時候甚至可能完全沒有任何病徵出現[4]。在感染細菌性陰道炎的情況下,另外感染其他性傳染病的機率大約提昇了一倍之多,而這當中包含了愛滋病(AIDS)[5][6]。此疾病也連帶提高了產婦早產的機率[7][8]

細菌性陰道炎和存在於陰道內的原生細菌失衡有關[9][10]。原先在陰道內常見的細菌發生了改變,且現有細菌數量以數百甚至數千倍的增加[2]。除了乳酸桿菌外,多了非常多其他的細菌[11]。危險因子包括沖洗陰道英语douching、新交或多重新伴侶、抗生素還有使用子宮環[10]。但不管怎麼說,細菌性陰道炎並不屬於性傳染病的一種[12]。診斷會建立在已有病症的情況下,接著檢測陰道分泌物再了解陰道內的pH值是否較正常為高,以及細菌數有無異常[2]。細菌性陰道炎常會和念珠菌性外阴阴道炎或是滴虫性阴道炎混淆[13]

治療細菌性陰道炎多使用抗生素,例如克林黴素甲硝唑。這些藥物都可以在孕期的第二或第三月期裡使用但是,在治療過後又常有復發的情形。益生菌據信可幫助預防降低復發的可能性[2]。目前還不清楚在懷孕時使用益生菌或抗生素對孕婦是否有任何影響[2][14]

細菌性陰道炎是育齡婦女常見的疾病[10],在特定時間中,女性感染的比率大約介於5-70%[5]。在非洲,女性患有此疾病的比例最高,但在亞洲與歐洲則都是相對較低的[5]。美國的統計數據顯示,在14至49歲的女性中,罹患細菌性陰道炎的百分比約是30%[15]。在每個國家裡,不同種族的感染比率大不相同[5]。歷史上,對於細菌性陰道炎的描述雖早已完備,但第一起有記錄在案的病例是1894年[1]

参考

  1. ^ 1.0 1.1 Borchardt, Kenneth A. Sexually transmitted diseases : epidemiology, pathology, diagnosis, and treatment. Boca Raton [u.a.]: CRC Press. 1997: 4. ISBN 9780849394768. 
  2. ^ 2.0 2.1 2.2 2.3 2.4 2.5 Donders, GG; Zodzika, J; Rezeberga, D. Treatment of bacterial vaginosis: what we have and what we miss.. Expert opinion on pharmacotherapy. April 2014, 15 (5): 645–57. PMID 24579850. doi:10.1517/14656566.2014.881800. 
  3. ^ Clark, Natalie; Tal, Reshef; Sharma, Harsha; Segars, James. Microbiota and Pelvic Inflammatory Disease. Seminars in Reproductive Medicine. 2014, 32 (01): 043–049. ISSN 1526-8004. PMC 4148456可免费查阅. PMID 24390920. doi:10.1055/s-0033-1361822. 
  4. ^ 4.0 4.1 4.2 What are the symptoms of bacterial vaginosis?. 2013-05-21 [3 March 2015]. 
  5. ^ 5.0 5.1 5.2 5.3 Kenyon, C; Colebunders, R; Crucitti, T. The global epidemiology of bacterial vaginosis: a systematic review.. American Journal of Obstetrics and Gynecology. December 2013, 209 (6): 505–23. PMID 23659989. doi:10.1016/j.ajog.2013.05.006. 
  6. ^ Bradshaw, CS; Brotman, RM. Making inroads into improving treatment of bacterial vaginosis - striving for long-term cure. BMC Infectious Diseases. July 2015, 15: 292. PMC 4518586可免费查阅. PMID 26219949. doi:10.1186/s12879-015-1027-4. 
  7. ^ Queena, John T. .; Spong, Catherine Y; Lockwood, Charles J., editors. Queenan's management of high-risk pregnancy : an evidence-based approach 6th. Chichester, West Sussex: Wiley-Blackwell. 2012: 262. ISBN 9780470655764. 
  8. ^ What are the treatments for bacterial vaginosis (BV)?. National Institute of Child Health and Human Development. 2013-07-15 [4 March 2015]. 
  9. ^ Bennett, John. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. 2015. ISBN 9781455748013. 
  10. ^ 10.0 10.1 10.2 Bacterial Vaginosis (BV): Condition Information. National Institute of Child Health and Human Development. 2013-05-21 [3 March 2015]. 
  11. ^ Nardis, C.; Mastromarino, P.; Mosca, L. Vaginal microbiota and viral sexually transmitted diseases. Annali di Igiene. September–October 2013, 25 (5): 443–56. PMID 24048183. doi:10.7416/ai.2013.1946. 
  12. ^ Bacterial Vaginosis – CDC Fact Sheet. 美国疾病控制与预防中心. March 11, 2014 [2 Mar 2015]. 
  13. ^ Mashburn, J. Etiology, diagnosis, and management of vaginitis.. Journal of midwifery & women's health. 2006, 51 (6): 423–30. PMID 17081932. doi:10.1016/j.jmwh.2006.07.005. 
  14. ^ Othman, M; Neilson, JP; Alfirevic, Z. Probiotics for preventing preterm labour.. The Cochrane database of systematic reviews. 24 January 2007, (1): CD005941. PMID 17253567. doi:10.1002/14651858.CD005941.pub2. 
  15. ^ Bacterial Vaginosis (BV) Statistics Prevalence. cdc.gov. September 14, 2010 [3 March 2015].