Influence of the normal menstrual cycle on vaginal tissue, discharge, and microflora
Influence of the normal menstrual cycle on vaginal tissue, discharge, and microflora
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DOI：
10.1086/313818
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发表时间：
2000-06-01
影响因子：
11.8
通讯作者：
Stamm, WE
中科院分区：
文献类型：
--
作者：
Eschenbach, DA;Thwin, SS;Stamm, WE
本研究的目的是检查无症状妇女月经周期3个阶段的生殖器组织、阴道液和阴道微生物植物群。对74名妇女进行了3次阴道检查：在月经期（第1-5天），排卵前期（第7-12天），以及排卵后阶段（第19-24天），将50名无细菌性阴道病（BV）妇女的植物群与24名BV妇女的植物群分开分析：在月经周期中，阴道分泌物量增加，宫颈粘液量减少。在没有BV的受试者中，任何乳杆菌的恢复率变化不大（范围，82%至98%; P = 0.2）;然而，月经周期中乳杆菌大量（3+至4+半定量）生长的恢复率略有增加（P = 0.04）。任何非乳杆菌属物种的重生长恢复率发生线性下降，从第1-5天的72%下降到第19-24天的40%（P = 0.002）。普雷沃氏菌属的回收率也出现线性下降，从第1-5天的56%下降到第19-24天的28%（P = .007），而脆弱拟杆菌的回收率出现小幅线性增加（P = .05）。在BV受试者中，唯一显着的变化是乳杆菌的回收率增加，从第1-5天的33%增加到第19-24天的54%（P = 0.008）。在所有受试者中，乳酸杆菌的大量生长的恢复率在月经周期中增加，相反，非乳酸杆菌物种的浓度在月经时倾向于更高，这证明阴道植物群在此时变得不太稳定。
The objective of this study was to examine genital tissue, vaginal fluid, and vaginal microbial flora at 3 phases of the menstrual cycle in asymptomatic women. Vaginal examinations were performed 3 times in 74 women: at the menstrual phase (days 1-5), the preovulatory phase (days 7-12), and the postovulatory phase (days 19-24), Flora of 50 women without bacterial vaginosis (BV) was analyzed separately from flora of 24 women with BV: The volume of vaginal discharge increased and the amount of cervical mucus decreased over the menstrual cycle. Among subjects without BV, the rate of recovery of any Lactobacillus changed little (range, 82% to 98%; P = .2); however, a small increase occurred in the rate of recovery of heavy (3+ to 4+ semiquantitative) growth of Lactobacillus over the menstrual cycle (P = .04). A linear decrease occurred in the rate of recovery of heavy growth of any non-Lactobacillus species, from 72% at days 1-5 to 40% at days 19-24 (P = .002). A linear decrease also occurred in the rate of recovery of Prevotella species, from 56% on days 1-5 to 28% on days 19-24 (P = .007), while a small linear increase occurred in the rate of recovery of Bacteroides fragilis (P = .05). Among subjects with BV, the only significant change was an increase in the rate of recovery of Lactobacillus, from 33% at days 1-5 to 54% at days 19-24 (P = .008). Among all subjects, the rate of recovery of heavy growth of Lactobacillus increased over the menstrual cycle and, in contrast, the concentration of non-Lactobacillus species tended to be higher at menses, which is evidence that the vaginal flora becomes less stable at this time.