مقایسه معیارهای بالینی آمسل با روش استاندارد رنگ‌آمیزی گرم در تشخیص واژینوز باکتریال

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد گروه مامایی و بهداشت باروری،کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استادیار گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استادیار گروه آمار زیستی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 دکترای تخصصی انگل‌شناسی، مرکز تحقیقات داروهای گیاهی رازی، دانشگاه علوم پزشکی لرستان، لرستان، ایران.

5 کارشناس ارشد میکروبیولوژی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

6 کارشناس علوم آزمایشگاهی، دانشکده پیراپزشکی، دانشگاه آزاد اسلامی واحد بروجرد، بروجرد، ایران.

چکیده

مقدمه: واژینوز باکتریال، شایع‌ترین نوع واژینیت در زنان سنین باروری است که توسط معیارهای بالینی آمسل و یا سیستم نمره‌دهی میکروسکوپی ناجنت (رنگ‌آمیزی گرم)، تشخیص داده می‌شود. مطالعه حاضر با هدف مقایسه معیارهای بالینی آمسل با روش استاندارد رنگ‌آمیزی گرم در تشخیص واژینوز باکتریال انجام شد.
روش‌کار: این مطالعه تجربی به‌منظور مقایسه معیارهای بالینی آمسل با روش استاندارد رنگ‌آمیزی گرم در تشخیص واژینوز باکتریال در سال 95-1394 بر روی 100 زن متأهل مراجعه‌کننده به درمانگاه‌های زنان شهر خرم‌آباد انجام شد. سیستم نمره‌دهی ناجنت به‌عنوان روش تشخیصی استاندارد طلایی واژینوز باکتریال در نظر گرفته شد. حساسیت، ویژگی، ارزش اخباری مثبت و ارزش اخباری منفی معیارهای آمسل با سیستم نمره‌دهی ناجنت مقایسه گردید. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 20) انجام شد. میزان p‌ کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: میانگین سن، طول مدت ازدواج، سن اولین قاعدگی و اولین بارداری واحدهای پژوهش به ترتیب 93/8±96/31، 50/3± 96/18، 85/0±99/12 و 84/3±03/20 سال بود. در ارزیابی ارزش تشخیصی سیستم نمره‌دهی ناجنت در مقایسه با معیارهای آمسل، معیارهای آمسل دارای حساسیت 100%، ویژگی 46%، ارزش اخباری مثبت 5/92% و ارزش اخباری منفی 100% بود.
نتیجه‌گیری: معیارهای آمسل به‌اندازه سیستم امتیازدهی ناجنت در تشخیص این عفونت دقت ندارند و رنگ­آمیزی گرم برای تشخیص صحیح واژینوز باکتریال نیاز است.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of Amsel Clinical Criteria with Standard Method of Gram Stain for Diagnosis of Bacterial Vaginosis

نویسندگان [English]

  • Asieh Azadpour Motlagh 1
  • Mahrokh Dolatian 2
  • Malihe Nasiri 3
  • Behrouz Ezatpour 4
  • Yadollah Sahranavard 5
  • Heshmat Shakiba 6
1 M.Sc. in Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Assistant professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Assistant professor, Department of Biosttistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 PhD in Parasitology, Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Lorestan, Iran.
5 M.Sc. in Microbiology, School of Paramedical, Jundishapur University of Medical Sciences, Ahvaz, Iran.
6 BC in Laboratory Sciences, School of Paramedical, Islamic Azazd University Borojerrd Branch, Borojerrd, Iran.
چکیده [English]

Introduction: Bacterial Vaginosis is the most common type of vaginitis in women of reproductive age which is diagnosed by Amsel’s clinical criteria and the Nugent microscopic scoring system (Gram stain). This study was performed with aim to compare Amsel clinical criteria with standard method of Gram stain for diagnosis of bacterial vaginosis.
Methods: The experimental study was conducted to compare Amsel's clinical criteria with standard gram stain method for diagnosis of bacterial vaginosis on 100 married women referred to women clinics of Khorramabad in 2015-2016. Nugent scoring system was considered as the gold standard method for diagnosis of bacterial vaginosis. Sensitivity, specificity, positive predictive value, and negative predictive value of Amsel's criteria was compared with those of the Nugent scoring system. Data was analyzed by SPSS software (version 20). P<0.05 was considered statistically significant.
Results: The mean of age, duration of marriage, age of the first menstruation and first pregnancy were 31.96 ± 8.93, 18.96 ± 3.50, 12.99± 0.85, and 20.03 ± 3.84 years. In the evaluation of diagnostic value of the Nugent scoring system in comparison with the Amsel's criteria, Amsel's criteria had sensitivity 100%, specificity 46%, positive predictive value 92.5%, and negative predictive value of 100%.
Conclusion: Amsel's criteria are not as accurate as the Nugent scoring system in the diagnosis of this infection and Gram staining is needed to correctly diagnose bacterial vaginosis.

کلیدواژه‌ها [English]

  • Amsel's criteria
  • Bacterial vaginosis
  • Gram staining
  • Nugent scoring system
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