Evaluation of clinical methods for diagnosing bacterial vaginosis
Evaluation of clinical methods for diagnosing bacterial vaginosis
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DOI：
10.1097/01.aog.0000145752.97999.67
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发表时间：
2005-03-01
影响因子：
7.2
通讯作者：
Blume, J
中科院分区：
文献类型：
--
作者：
Gutman, RE;Peipert, JF;Blume, J
目的：为了确定目前的临床标准诊断细菌性阴道病是否可以简化使用2个临床标准，而不是标准的3个4 criteria（Amsel's criteria）：这是一个前瞻性的观察性研究，269名妇女进行阴道检查，在妇女的初级保健中心，研究部门，或阴道镜诊所在妇女和婴儿医院。收集细菌性阴道病的4项临床诊断标准，以革兰氏染色为金标准。计算每个单独标准、标准组合以及比色pH和胺卡的灵敏度和特异性。结果：细菌性阴道病的患病率为38.7%。阴道pH值是所有标准中最敏感的，为89%，阳性胺气味是特异性最高的个体标准，为93%。2个标准和Amsel标准的组合观察到相似的特异性。受试者工作特征曲线分析得出了一个优选的pH值和百分比，由于细胞分别为5.0和20%。然而，pH值为4.5或更高，提高敏感性与最小的损失specificity.CONCLUSION：新的临床标准诊断细菌性阴道病可以简化为2个临床标准，而不损失敏感性和特异性。(C)2005年由美国妇产科医师学会。
OBJECTIVE: To determine whether the current clinical criteria for diagnosing bacterial vaginosis can be simplified by using 2 clinical criteria rather than the standard 3 of 4 criteria (Amsel's criteria).METHODS: This was a prospective observational study of 269 women undergoing a vaginal examination in the Women's Primary Care Center, Division of Research, or Colposcopy Clinic at Women & Infants Hospital. All 4 clinical criteria for diagnosing bacterial vaginosis were collected, and Gram stain was used as the gold standard. Sensitivity and specificity were calculated for each individual criterion, combinations of criteria, and a colorimetric pH and amine card. Receiver operating characteristic curve was generated to estimate the preferred pH and percentage of due cells for diagnosing bacterial vaginosis.RESULTS: The prevalence of bacterial vaginosis in our study population was 38.7%. Vaginal pH was the most sensitive of all the criteria, at 89%, and a positive amine odor was the individual criteria with the highest specificity, at 93%. Similar specificity was seen with combinations of 2 criteria and Amsel's criteria. Receiver operating characteristic curve analysis yielded a preferred pH and percentage of due cells of 5.0 and 20%, respectively. However, a pH of 4.5 or greater improves sensitivity with minimal loss of specificity.CONCLUSION: ne clinical criteria for diagnosing bacterial vaginosis can be simplified to 2 clinical criteria without loss of sensitivity and specificity. (C) 2005 by ne American College of Obstetricians and Gynecologists.