背景:溶细胞性阴道病(CV)鲜为人知,有争议的情况,通常不考虑出现外阴阴道炎症状的女性。目标:本范围审查的目的是确定和汇编关于CV的全球证据。
方法:一位医学图书馆员搜索了Prospero,WileyCochrane图书馆,OvidEmbase,OvidMedline,EBSCOCINAHL,ProQuest论文和论文全球,还有Scopus,从成立到2019年4月4日,并更新到2021年10月17日。如果他们讨论CV,研究就有资格。两名独立的审稿人进行了研究选择和数据提取。
结果:确定了64项研究,67%的研究(n=43)自2007年以来发表。研究来自世界各地,包括美国(28%,n=18),巴西(11%,n=7),葡萄牙(11%,n=7),和中国(11%,n=7)。50%的研究(n=32)是综述;其余的是观察性的;其中,78%(n=25)为横截面。最常见的主题包括:诊断(19%,n=12),患病率(17%,n=11),和CV概述(50%,n=32)。有症状女性患病率的证据(中位患病率为5%,四分位数间距3%-8%)仅基于16%的研究(n=10),关于无症状妇女和不同地理区域患病率的证据很少。微生物学发现,包括丰富的乳酸杆菌和破碎的上皮细胞,被发现有助于区分CV和外阴阴道念珠菌病,在CV女性中,crispatus乳杆菌在阴道菌群中占主导地位。大多数研究使用主观标准来诊断CV,因为这种情况缺乏金标准的显微镜标准。建议的初级处理(小苏打灌溉)主要基于专家意见,关于CV和其他条件之间的关联的证据很少。
结论:目前在CV研究的所有领域都存在知识差距。需要进一步的研究来确认CV的有效性,并确保女性得到有效的诊断和治疗。
Cytolytic vaginosis (CV) is a little-known, controversial condition that is typically not considered for women presenting with vulvovaginitis symptoms. Objective: The objective of this scoping
review was to identify and compile the global evidence on CV.
A medical librarian searched Prospero, Wiley Cochrane Library, Ovid Embase, Ovid Medline, EBSCO CINAHL, ProQuest Dissertations and Theses Global, and Scopus, from inception to April 4, 2019 and updated to October 17, 2021. Studies were eligible if they discussed CV. Two independent reviewers conducted study selection and data extraction.
Sixty-four studies were identified, with 67% of studies (n = 43) published since 2007. Studies were from around the world, including the United States (28%, n = 18), Brazil (11%, n = 7), Portugal (11%, n = 7), and China (11%, n = 7). Fifty percent of studies (n = 32) were reviews; the remainder were observational; and of these, 78% (n = 25) were cross-sectional. The most frequent topics included: diagnosis (19%, n = 12), prevalence (17%, n = 11), and overview of CV (50%, n = 32). Evidence for prevalence in symptomatic women (median prevalence of 5%, interquartile range 3%-8%) was based only on 16% of studies (n = 10) with minimal evidence on prevalence in asymptomatic women and across different geographic regions. Microbiological findings, including abundant lactobacilli and fragmented epithelial cells, were found useful to distinguish between CV and vulvovaginal candidiasis, and Lactobacillus crispatus was noted to dominate the vaginal flora in women with CV. Most studies used subjective criteria to diagnose CV as the condition lacks gold-standard microscopic criteria. The suggested primary treatment (baking soda irrigations) was largely based on expert opinion, and there was minimal evidence on associations between CV and other conditions.
Knowledge gaps currently exist in all realms of CV research. Additional research is needed to confirm the validity of CV and ensure that women are diagnosed and treated effectively.