了解未足月胎膜早破患者阴道微生态的状况，探讨未足月胎膜早破(preterm premature rupture of membranes, PPROM)孕妇阴道微生态评价的临床意义。

选取2013年1月至2013年12月在伊犁州友谊医院常规进行产前检查，孕28～36^＋6周PPROM孕妇150例为PPROM组，同孕周正常孕妇150例为对照组，采集两组患者阴道分泌物，革兰染色涂片后进行阴道微生态学评价；计数资料比较采用t检验，计量资料比较采用χ²检验。

PPROM组阴道优势菌以革兰阳性球菌为主(34.67%，52/150)，与对照组(12.00%，18/150)比较，χ²＝21.54，P<0.01，差异有统计学意义；对照组以革兰阳性杆菌为主(67.33%，101/150)，与PPROM组(31.33%，47/150)比较，χ²＝38.89，P<0.01。PPROM组正常菌群密集度(Ⅱ级和Ⅲ级)的比例(63.33%，95/150)，与对照组(88.00%，132/150)比较，χ²＝17.28，P<0.01，差异有统计学意义；PPROM组正常菌群多样性(Ⅱ级和Ⅲ级)(60.00%，95/150)，与对照组(90.67%，136/150)比较，χ²＝37.96，P<0.01。PPROM组孕妇的细菌性阴道病(BV)、外阴阴道假丝酵母菌病(VVC)、BV＋VVC及菌群失调者的发生率分别为(21.33%，32/150)、(24.00%，36/150)、(13.33%，20/150)、(32.00%，48/150)对照组分别为(10.67%，16/150)、(10.67%，16/150)、(1.33%，2/150)、(20.67%，31/150)，两组比较χ²值分别为6.33、9.27、27.33和4.95，P值分别为＝0.01、<0.01、<0.01和<0.05，差异均有统计学意义。PPROM组中无症状者有33.81%，处于微生态失调状态。

未足月胎膜早破孕妇阴道微生态改变表现为微生态失调比例升高。

To investigate the vaginal microecosystem condition and evaluate the clinical significance of vaginal microflora in the patients with preterm premature rupture of membrane(PPROM).

A retrospective study was conducted in 300 pregnant women of 28-36^{+ 6} gestational weeks, who were admitted in Yili State Youyi Hospital from January 2013 to December 2013. One hundred and fifty pregnancy women with preterm premature rupture of membranes were in the PPROM group, and 150 patients without PPROM were in the control group. Microecological evaluation of vaginal discharge was performed by Gram stained. Enumeration data were analyzed by t test and measurement data were analyzed by Chi-square test.

In the PPRPM group, 53 cases of 150 cases were Gram-positive coccus (34.67%). Compared with the control group (12.00%, 18/150), there was significant difference ( χ²=21.54, P<0.01). In the control group, 101 cases of 150 cases were Gram-positive bacilli (67.33%). Compared with the PPROM group (31.33%, 41/150), there was significant difference ( χ²=38.89, P<0.01). The rate of normal floraintensity (63.33%, 95/150) in the PPROM groupversus (88.00%, 132/150) in the control group ( χ²=17.28, P<0.01). The rate of normal bacterial diversity(60.00%, 95/150) in the PPROM group versus (90.67%, 136/150) in the control group ( χ²=37.96, P<0.01). The incident rate of bacterial vaginosis (BV), vulvovaginalcandidiasis (VVC), BV with VVC, and vaginal dysbacteriosisin the PPROM group were 21.33% (32/150), 24.00% (36/150), 13.33% (20/150) and 32.00% (48/150), respectively. In the control group, the incidence rate of BV, VVC, BV with VVC, and vaginal dysbacteriosis were 10.67% (16/150), 10.67% (16/150), 1.33% (2/150) and 20.67% (31/150), respectively.Compared in the two group, 2 value were 6.33, 9.27, 27.33, 4.95, respectively, which were significant difference(P=0.01, <0.01, <0.01, <0.05). In the PPROM group, 33.81% patients had vaginal microecological disturbance without any symptoms.

The incident rate of vaginal microecological disturbancewas increased in the PPROM patients.