Abstract
目的 调查孕妇外阴阴道念珠菌病(vulvovaginal candidiasis,VVC)的发病率,对检出的VVC进行病原学和治疗研究. 方法连续对产科门诊1000例孕妇进行VVC发病情况调查.对分离的念珠菌进行体外抗真菌药物敏感试验.对66例VVC患者应用咪康唑栓治疗,400 mg/d,6 d为一疗程. 结果孕妇VVC的发病率为12.7%(127/1000).37.4%(374/1000)的孕妇以往有VVC病史,0.6%的孕妇为复发性VVC.127例VVC中,白念珠菌、光滑念珠菌、热带念珠菌和克柔念珠菌分别占87.1%、9.9%、1.5%和1.5%.有4例患者同时感染2种念珠菌.114株白念珠菌对咪康唑、克霉唑、氟康唑、伊曲康唑、制霉菌素耐药率依次为10.5%、2.6%、 6.1%、7.9%和0.13株光滑念珠菌对咪康唑和制霉菌素均敏感,对克霉唑、伊曲康唑和氟康唑均敏感或剂量依赖敏感.应用咪康唑栓治疗的患者在治疗完成后1～2周及4～6周的病原学治愈率分别为84.8%和80.3%. 结论 VVC是孕妇的常见病,白念珠菌仍然是主要致病菌,其次为光滑念珠菌.常用抗真菌药物对引起VVC的念珠菌存在不同程度的耐药率,应用咪康唑栓治疗孕妇VVC效果满意。
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