妊娠期外阴阴道假丝酵母菌病阴道乳杆菌的变化  

Changes of vaginal lactobacillus in women with vulvovaginal candidiasis during pregnancy

作　　者：周丹[1] 崔颖[2] 张瑞[1] 廖秦平[1] 

机构地区：[1]北京大学第一医院妇科,100034 [2]卫生部北京医院妇科,100730

出　　处：《中国生育健康杂志》2013年第3期179-184,共6页Chinese Journal of Reproductive Health

基　　金：国家自然科学基金项目（81170535）

摘　　要：目的探讨妊娠期外阴阴道假丝酵母菌病（VVC）患者与妊娠期健康妇女、非妊娠期VVC患者相比阴道内乳杆菌种类的变化，检测3组中优势菌卷曲乳杆菌产过氧化氢（H2O2）和产酸能力。方法选取妊娠期VVC组和妊娠期健康组各24例，非妊娠期VVC组62例，通过种特异性聚合酶链反应（PCR）法检测阴道分泌物中的乳杆菌分布；比较妊娠期VVC组，妊娠期健康组，非妊娠期VVC组卷曲乳杆菌产H2O2和产酸能力。结果（1）妊娠期VVC组、妊娠期健康组和非妊娠期VVC组阴道内惰性乳杆菌检出率分别为8．3％，62．5％，6．5％，妊娠期VVC组与妊娠期健康组比较，差异有统计学意义；卷曲乳杆菌检出率分别为83．3％，66．7％和79．0％，3组比较，差异无统计学意义；嗜酸乳杆菌检出率分别为50．0％，58．3％和16．1％，妊娠期VVC与非妊娠期VVC比较，差异有统计学意义；（2）妊娠期健康组、妊娠期VVC组和非妊娠期VVC组卷曲乳杆菌产H2O2的量分别为（2．5±0．2）mmol／L，（2．0±0．1）mmol／L和（2．0±0．1）mmol／L，妊娠期健康组卷曲乳杆菌产H2O2功能强于妊娠期VVC组和非孕期VVC组，差异有统计学意义，妊娠期VVC组与非妊娠期VVC组卷曲乳杆菌产H2O2功能比较，差异无统计学意义；（3）妊娠期健康组、妊娠期VVC组和非妊娠期VVC组卷曲乳杆菌产酸能力分别为（7．1×10^-5±3．1×10^-5）mol／L、（5．9×10^-5±2．5×10^-5）mol／L和（4．5×10^-5±2．0×10^-5）mol／L，妊娠期健康组分离的乳杆菌产酸能力强于妊娠期VVC组，妊娠期VVC组分离的乳杆菌产酸能力强于非孕期VVC组，差异均有统计学意义。结论惰性乳杆菌可能是阴道微环境改变的一个标志物；卷曲乳杆菌均为3组女性阴道内优势菌；尽管VVC患者阴道内卷曲乳杆菌检出率无减少，但卷曲乳杆菌的产H2O2和产酸能力下降。Objective To investigate the distribution and function of lactobacillus in the vaginas of pregnant women with vulvovaginal candidiasis （WC）, healthy pregnant women, and non-pregnant women with WC. Methods Vaginal sampies from 24 pregnant women with VVC, 24 healthy pregnant women, and 62 non-pregnant women with VVC were analyzed using species-specific PCR followed by sequencing. The samples were cultured in Rogosa and MRS media. Lactobacillus crispatus strains from three groups were assessed for hydrogen peroxide （ H2O2 ） and acid production. Results （ 1 ） The rate of lactobacillus iners isolated in the vaginas of pregnant women with VVC, healthy pregnant women, and non-pregnant women was 8.3%, 62.5%, and 6. 5%, respectively. The rate oflactobacillus iners in pregnant women with VVC was significandy lower than that in healthy pregnant women. The most frequent species in the three groups were lactobaciUus crispatus, with a rate of 83. 3%, 66.7%, and 79. 0%, respectively. No statistical difference was observed between any of the two comparisons. The rate of lactobacillus aeidophilus isolated from these three groups was 50. 0%, 58. 3%, and 16. 1%, respectively, with a higher rate in pregnant women with VVC than that in non-pregnant women with VVC; （2） Level of H2 02 generated from lactobacillus crispatus isolated from healthy pregnant women, pregnant women with VVC, and non-pregnant women with VVC was （2. 5 ± 0. 2） mM, （2.0 ± 0. 1 ） mM, and （2. 0 ± 0. 1 ） mM, respectively, with a higher H2O2 level in healthy pregnant women than that in any of the other two groups. Level of acid from lactobacilhts crispatus isolated from the three groups was （7.1 × 10 ^-5 ± 3.1 × 10^ -5 ） mol/L, （5.9 × 10 ^-5 ± 2. 5 × 10^ -5 ） mol/L, and （4. 5 × 10^-5 ±2. 0 × 10^-5） mol/L, respectively, with a higher level in healthy pregnant women than that in pregnant women with VVC, and a higher level in pregnant women with VVC than that in non-pregnant women with VVC. Conclusion Lactobacillus ine

关 键 词：乳杆菌 外阴阴道假丝酵母菌病 妊娠 酸碱度 过氧化氢 

分 类 号：R711.31[医药卫生—妇产科学]