利用X-Neu5Ac为底物测定唾液酸酶活性在诊断细菌性阴道病的价值  

Diagnosis of bacterial vaginosis by detection of sialidase activity using 5-bromo-4-chloro-3-indolyl-alpha-D-N-acetylneuraminic acid as the substrate

作　　者：楼永良[1] 刘佳明[2] 

机构地区：[1]温州医学院检验医学院,浙江温州325035 [2]温州医学院公共卫生学院,浙江温州325035

出　　处：《中国微生态学杂志》2006年第2期102-103,106,共3页Chinese Journal of Microecology

基　　金：温州市科技计划项目(Y2004a117)

摘　　要：目的利用5溴-4氯-3吲哚乙酰基神经氨酸盐(X-Neu5Ac)为底物测定阴道唾液酸酶活性诊断细菌性阴道病(bacterial vaginosis,BV)的价值。方法健康妇女30例,临床Am sel法诊断为BV的患者45例,共计75例进行了阴道分泌物分析和检测,并与唾液酸酶活性法诊断作了对比研究。取阴道分泌物作为标本分别进行唾液酸酶活性和阴道菌群定量分析,检测细菌包括乳酸杆菌、类杆菌、肠杆菌、葡萄球菌、肠球菌和阴道加德纳菌。唾液酸酶活性测定利用的底物为X-Neu5Ac,特异活性用其产物———甲氧基苯酚的纳摩尔数来表示。结果阴道液唾液酸酶活性测定诊断细菌性阴道病的敏感性、特异性、阳性预期值和阴性预期值分别为88.9%、90%、93%和84.3%。唾液酸酶法在检测细菌性阴道病上和传统的Am sel法比较,差异无显著性(P>0.05)。唾液酸酶阳性组Gv活菌数(6.96 log CFU/g)明显高于唾液酸酶阴性组(2.05 log CFU/g)(P<0.01)。唾液酸酶阳性组产H2O2阴道乳杆菌(LB+)活菌数(4.26 Log CFU/g)明显低于唾液酸酶阴性组(8.66 Log CFU/g)(P<0.01)。唾液酸酶阳性组与唾液酸酶阴性组两组的阴道液中需氧菌活菌数差异无显著性(P>0.05),主要包括金黄色葡萄球菌、肠球菌和肠杆菌。结论利用X-Neu5Ac作为唾液酸酶的底物测定唾液酸酶活性的方法是诊断细菌性阴道病的有效检测方法。阴道内唾液酸酶活性增强,厌氧菌数量增加,LB+数量减少,提示BV发生恶化。Objective To evaluate on measuring vaginal sialidase activity to identify bacterial vaginosis （BV） by using 5-bromo-4-chloro-3-indolyl-alpha-D-N-acetylneuraminic acid （X-Neu5Ac） as the substrate. Methods The study population comprised 45 of them with clinical signs of BY （ BY ＋ ） and 30 of them without BY （BV - ）. Bacterial vaginosis was diagnosed by clinical criteria. The vaginal fluids from suspected patients were evaluated by sialidase levels and collected for quantitative determination, including Lactobacillus spp, Bacteroicles spp, Escherichia coli, Staphylococcus spp, Streptococcus spp, C, ardnerella vaginalis. Sialidase activity using X-Neu5Ac as the substrate, specific activity was expressed as nanomoles of methoxyphenol produced. The method of measuring vaginal sialidase activity was compared to the standard method for diagnosing BV （Amsel criteria）. Results The sensitivity and specificity of the test for prediction of BV were 88.9% and 90%, respectively, with no significant differences （P 〉 0.05） from those by Amsel criteria. Positive and negative predictive values were 93% and 84.3%, respectively. The mean Gardnerella vaginalis count in the sialidase-positive group was 6.95 log colony-forming units （CFU）/g, which was significantly higher （P 〈 0.01 ） than that （2.05 log CFU/g） in the sialidase-negative group. The mean count of hydrogen peroxide-producing Lactobacilli （LB^＋ ） species was significantly higher （ P 〈 0.05 ） in the sialidase-negative group than in the positive counterpart （4.26 vs 8.66 ）. In contrast, there was no difference in the mean total aerobe count between the two groups, including Staphylococcus spp,Enterococcus spp and Escherichia coli. Conclusions The vaginal sialidase activity for identifing bacterial vaginosis （BV） by using X-Neu5Ac as the substrate was a useful diagnostic tool of BY. Elevation of vaginal sialidase activity, an increase in the anaerobe count, and decreases in LB ~ count could be good predictors of the

关 键 词：唾液酸酶 X-Neu5Ac 细菌性阴道病 阴道加德纳菌 

分 类 号：R378[医药卫生—病原生物学]