光滑念珠菌性外阴阴道炎抗真菌物药敏感试验和治疗-临床医学(妇产科学)专业论文.docxVIP

汕头大学硕士研究生学位论文 汕头大学硕士研究生学位论文 汕头大学硕士研究生学位论文 汕头大学硕士研究生学位论文 I I II II 中文摘要 目的 通过研究光滑念珠菌对抗真菌药物的敏感性，并对比分析制霉菌素栓、硝酸咪康唑 阴道栓、氟康唑胶囊和伊曲康唑治疗光滑念珠菌性外阴阴道炎的临床疗效，寻找治疗光 滑念珠菌性外阴阴道炎的最有效药物。 方法 选择2008年10月至2010年9月在北京大学深圳医院妇科门诊诊治的光滑念珠菌性外 阴阴道炎患者68例，回顾性分析四种不同药物治疗光滑念珠菌性外阴阴道炎的临床疗 效，并用固体琼脂制片扩散法行药敏试验。 结果 选择完成治疗及随访的患者制霉菌素组16例，达克宁组28例，伊曲康唑组15例，氟 康唑组9例。63株光滑念珠菌的药敏试验结果为：对制霉菌素、咪康唑、氟康唑、伊曲 康唑和克霉唑的敏感率（含中介）分别为100％（62/62例，）、100％（63/63例）、94.23％ （49/52例）、98.00％（49/50例）、93.33％（56/60例）；耐药率分别0％、0％、5.77％ （3/52例）、2.00％（1/50例）、6.67％（4/60例），p0.05。完成治疗后7天～14天 制霉菌素组、达克宁组、氟康唑组和伊曲康唑组的治愈率分别为93.75％（15/16例）、 60.71％（17/28例）、55.56％(5/9例)和46.67％(7/15例)，p0.05；治疗后30天～35 天的治愈率分别为81.25％（13/16例）、50.00％（14/28例）、55.56％(5/9例)和46.67％ (7/15例)，p0.05。 结论 制霉菌素栓 20万U，连续7天阴道用药治疗光滑念珠菌性外阴阴道炎的疗效最好。所有 光滑念珠菌株均对制霉菌素敏感。 关键词:光滑念珠菌性外阴阴道炎；制霉菌素；氟康唑；伊曲康唑；咪康唑 Abstract Object To study the efficacy of nystatin, fluconazole, itraconazole and miconazole in the treatment of Candida glabrata vaginitis and to explore the relation between the in vitro susceptibility test results of Candida glabratas in vagina and the efficacy of treatment with these four drugs. Methods Sixty eight patients with Candida glabrata vaginitis were incruited. The patients with Candida glabrata vaginitis were treated with nystatin pessary, or miconazole nitrate pessary,or oral fluconazole, or itraconazole.They were followed at 7～14day and 30～35 day afer treatment. In vitro susceptibility of Candida glarata isolates was tested. Results The susceptibility rate (including mid-susceptibility ) of Candida glabrata to nystatin, miconazole, fluconazole, itraconazole and clotrimazole were 100%, 100%, 94.23%, 98.00%, 93.33%, respectively;resistance rate were 0%, 0%, 5.77%, 2.00%, 6.67%, respectively, p0.05.The mycologic eradication rate of nystatin,fluconazole, itraconazole and miconazole at day 7 ～ 14 days was 93.75%,55.56%,46.67% and 60.71%, respectively, p0.05; and that at day 30～ 35 days was 81.25%,55.56%, 46.67%, and 50.00%,respectively, p0.05. Conclusion Nystatin was the most effective