萎缩性阴道炎患者的阴道菌群结构分析  

The profiles of vaginal microbiota in postmenopausal women with atrophic vaginitis

作　　者：葛覃[1] 沈健[1] 刘延[1] 滕宗荣[1] Ge Tan;Shen Jian;Liu Yah;Teng Zongrong(Ruijin Hospital Affiliated to Medical School of Shanghai Jiao Tong University,Shanghai 200025,Chin)

机构地区：[1]上海交通大学医学院附属瑞金医院,200025

出　　处：《中华生殖与避孕杂志》2018年第6期464-471,共8页Chinese Journal of Reproduction and Contraception

摘　　要：目的揭示萎缩性阴道炎患者阴道群落特征,并探讨阴道菌群结构与萎缩性阴道炎发病之间的潜在关联。方法共纳入30名萎缩性阴道炎患者参与本研究(萎缩性阴道炎组),另有30名进行体检的绝经后健康妇女作为对照组。以16S r RNA基因为研究靶点,采用Illumina第二代高通量测序技术结合生物信息学分析,得阴道菌群结构数据。采用正则变量的逐步判别分析,对两组间群落组成的关联和差异进行比较。采用Spearman等级回归分析,探讨单个物种数量与疾病严重程度间的关系。结果在所有60例中,总共测得288个属的细菌。萎缩性阴道炎组和对照组间阴道菌群总体结构差异有统计学意义(P<0.05)。其中12个属的主要细菌相对丰度差异显著。在绝经后正常妇女的阴道内,乳酸杆菌占据整个阴道微生物群落主导地位。萎缩性阴道炎组阴道加德纳菌相对丰度(41.7%)显著高于对照组(16.7%,P<0.000 1),并取代乳酸杆菌成为阴道群落中生物优势最大的种群。萎缩性阴道炎组的乳酸杆菌失去了其生物优势地位,相对丰度(11.2%)显著低于对照组(53.2%,P<0.000 1)。相关性分析显示,萎缩性阴道炎组患者生殖道症状的严重程度与乳酸杆菌的相对丰度呈显著负相关(r=-0.301,P<0.001),而与加德纳菌(r=0.278,P<0.001)及奇异菌属(r=0.166,P<0.05)的数量呈显著正相关。结论阴道微生物群落失衡与萎缩性阴道炎发病存在关联。对于绝经后女性而言,处于生物优势地位的乳酸杆菌在维持阴道健康方面起到更为重要的作用。而阴道加德纳菌属和奇异菌属与绝经后妇女生殖道萎缩症状的严重程度有关,且这2种微生物的过度生长可能增加了罹患萎缩性阴道炎的风险。Objective To identified the profiles of vaginal microbiota in postmenopausal women with or without atrophic vaginitis（AV）, and investigate the potential correlations between vaginal bacterial composition and AV pathogenesis. Methods Thirty eligible patients, who were suffering with AV, were designated as AV group. In addition, a group of post-menopausal women remaining genital symptoms free were enrolled and designated as control group. The structure of bacteria communities present in the samples were identified by classifying 16 S r RNA gene sequences in each sample using next-generation deep sequencing and bioinformatic analysis. To investigate differences of community composition between the two groups, a stepwise discriminant analysis was performed using the log-ratio-transformed proportions and canonical transformation for the species. In order to determine if a statistical relationship existed between species relative abundance and genital symptom score, the Spearman＇s correlation coefficient analysis were used. Results A total of 60 vaginal samples were sequenced and the retrieved sequences were from 288 genera. The canonical variable transformed from total species proportions differed significantly between AV group and control group（P〈0.05）, while the relative abundance of 12 key vaginal genera were also significantly different between groups. Lactobacilli universally existed in most healthy post-menopausal women＇s vaginal communities with a predominant abundance. The relative abundance of Gardnerella（41.7%） in AV women significantly increased compared with control group（16.7%） and played a dominant role in vaginal communities in place of Lactobacilli（53.2%, P〈0.000 1）. Meanwhile, the relative abundance of Lactobacilli in AV group significantly decreased from 53.2% to 11.2%（P〈0.000 1）, and lost its biological superiority. The results also indicated that among the most 5 key taxa present in all communities, Lactobacillus was negative correlated（r=-0.301, P〈0.001） wit

关 键 词：阴道菌群 萎缩性阴道炎 乳酸杆菌 奇异菌 加德纳菌 

分 类 号：R711.31[医药卫生—妇产科学]