表面活性蛋白A在复发性外阴阴道假丝酵母菌病患者治疗前后阴道局部的表达  

Local expression of surfactant protein A in the vagina of the patients with RVVC before and after treatment

作　　者：杨兰英[1] 贾俊茹[1] 王素芬[1] 李凤文[1] 

机构地区：[1]河北省廊坊市人民医院妇产科,河北廊坊065000

出　　处：《实用临床医药杂志》2013年第5期43-46,共4页Journal of Clinical Medicine in Practice

摘　　要：目的观察复发性外阴阴道假丝酵母菌病(RVVC)患者阴道局部表面活性蛋白A(SP-A)水平的变化,探讨其与RVVC发生、转归的关系,并分析氦-氖激光(He-Ne)照射作为维持治疗对阴道SP-A的影响。方法对68例RVVC患者(观察组)在急性期、初始抗真菌治疗后、He-Ne激光维持治疗2个疗程后,随访其治疗效果并采用ELISA方法测定阴道分泌物SP-A水平,同期检测40例健康育龄妇女(对照组)阴道分泌物标本SP-A。结果对照组SP-A为(7.24±0.76)nmol/L;观察组RVVC急性期为SP-A(1.95±0.72)nmol/L,初始治疗后为(2.92±0.53)nmol/L,与急性发作期相比升高(P<0.05);He-Ne激光治疗第1个疗程后SP-A(3.64±0.62)nmol/L,与激光治疗前相比明显升高(P<0.05);激光治疗第2个疗程后SP-A(4.27±0.56)nmol/L,比第1个疗程后升高(P<0.05);观察组停止治疗6个月后复查时阴道局部SP-A(3.91±0.35)nmol/L,与激光治疗第2个疗程后相比差异无统计学意义,但比对照组低(P<0.01);RVVC疾病过程中的不同阶段SP-A与对照组相比均明显降低(P<0.01)。结论妇女阴道局部存在SP-A,SP-A的降低可能与RVVC的发病有关;He-Ne激光局部照射使阴道内SP-A水平升高,从而为He-Ne激光局部照射治疗的有效性提供了佐证;RVVC患者阴道内SP-A持续低值可能是容易复发的因素之一。Objective To observe the change of surfactant protein A（SP-A） level from the local vagina of the patients with recurrent vulvovaginal candidiasis （RVVC）, discuss the relationship of the development and lapsing between SP-A and RVVC and analyze the effect of He-Ne laser （He -Ne） irradiation as the maintenance therapy on vaginal SP-A. Methods After initial antifungal treatment in the acute phase and adopting the maintenance therapy with He-Ne laser treatment for two courses for RVVC patients （observation group）, the treatment effect were followed up and the SP-A level of vaginal secretion were determined with ELISA method. At the same time, SP-A of the vaginal secretion specimen from healthy women of child-bearing age were detected and taken as control group. Results SP-A was （7.24 ± 0.76） nmol/L in control group with （1.95 ± 0.72） nmol/L in the acute phase of RWC. After initial treatment, SP-A reached （2.92 ± 0.53） nmol/ L, which was elevated comparing with that of acute episode （P〈0.05）. SP-A was （3.64 ±0.62） nmol/L after the first treatment course with He-Ne laser, which got significant elevation comparing with that before laser treatment （P〈 0.05）. After the second treatment course with laser, SP-A was （4.27± 0.56） nmol/L, which was elevated comparing with that of the first treatment course （ P 〈 0.05）. On re-examination sixth months after stopping treatment, there was no significant difference for （3.91 ± 0.35） nmol/L of SP-A from local vagina in the observation group comparing with that of the laser treatment group after the second treatment course, but it was lower than that of the control group （P〈0. 001）. There was significant decrease in SP-A from each group at various stages of RVVC process comparing with that of the control group （P〈 0. 001）. Conclusion SP-A exists in local vagina, and the reduction of SP-A may be related to the development of RVVC. The local irradiation with He-Ne laser may elevate SP-A level in vagina, thus, i

关 键 词：复发性外阴阴道假丝酵母菌病 阴道 表面活性蛋白A HE-NE激光 

分 类 号：R711.73[医药卫生—妇产科学]