孕期霉菌性阴道炎患者阴道微生态和局部免疫功能变化的分析  

Changes of vaginal microecology and local immune function in patients with mycotic vaginitis during pregnancy and their clinical significance

作　　者：金明红 孙晴晴 张沙沙 Jin Minghong;Sun Qingqing;Zhang Shasha(Department of Obstetrics,Central Hospital of Qingdao West Coast New Area,Qingdao 266555,China)

机构地区：[1]青岛西海岸新区中心医院产科,山东青岛266555

出　　处：《中国临床实用医学》2020年第4期44-47,共4页China Clinical Practical Medicine

摘　　要：目的:探讨孕期霉菌性阴道炎患者阴道微生态和局部免疫功能变化及临床意义。方法:选取2017年12月至2018年12月青岛西海岸新区中心医院产科收治的50例孕期霉菌性阴道炎患者为阴道炎组,年龄(29.57±2.36)岁,年龄范围为24~38岁。另选取同期产检的70例健康孕妇为健康组,年龄(28.89±2.29)岁,年龄范围为24~36岁。比较两组纳入者pH值、白细胞介素-1β(IL-1β)、分泌性免疫球蛋白A(sIgA)和乳酸脱氢酶(LDH)水平、菌群密集度、菌群多样性和局部免疫功能[白细胞介素2(IL-2)、白细胞介素10(IL-10)、白细胞介素12(IL-12)、γ干扰素(IFN-γ)]情况。结果:阴道炎组pH值(6.04±0.05)、IL-1β[(132.49±15.49)mg/L]水平高于健康组[(5.41±0.04)、(83.29±12.45)mg/L],sIgA[(156.74±18.49)U/L]和LDH[(53.29±8.29)U/L]水平低于健康组[(212.57±23.49)U/L、(82.35±10.42)U/L],差异有统计学意义(P<0.05)。阴道炎组菌群密集度菌群多样性Ⅰ级[24.0%(12/50)]和Ⅱ级[34.0%(17/50)]高于健康组[10.0%(7/70)、17.1%(12/70)],Ⅲ级[42.0%(21/50)]低于健康组[72.9%(51/70)],差异有统计学意义(P<0.05);两组纳入者Ⅳ级比较,差异无统计学意义(P>0.05)。阴道炎组菌群密集度菌群多样性Ⅰ级[42.0%(21/50)]高于健康组[21.4%(15/70)],Ⅱ级[58.0%(29/50)]低于健康组[78.6%(55/70)],差异有统计学意义(P<0.05);两组纳入者Ⅲ级、Ⅳ级比较,差异无统计学意义(P>0.05)。阴道炎组IL-2[(17.45±4.95)pg/ml]、IL-10[(156.95±4.29)pg/ml]、IL-12[(278.96±55.29)pg/ml]、IFN-γ[(97.37±15.45)pg/ml]水平高于健康组[(11.79±2.65)pg/ml、(128.16±2.03)pg/ml、(201.46±43.27)pg/ml、(68.43±10.94)pg/ml],差异有统计学意义(P<0.05)。结论:孕期霉菌性阴道炎患者阴道内微生态环境发生紊乱,阴道局部免疫状态发生变化,细胞免疫功能不足,从而导致霉菌性阴道炎的发生。Objective To investigate the changes and clinical significance of vaginal microecology and local immune function in patients with mycotic vaginitis during pregnancy.Methods From December 2017 to December 2018,50 patients with mycotic vaginitis during pregnancy who were admitted in the department of Obstetrics,Central Hospital of Qingdao West Coast New Area were selected as the vaginitis group,aged(29.57±2.36)years old,ranging from 24 to 38 years old.Another 70 healthy pregnant women were selected as the healthy group,aged(28.89±2.29)years old,ranging from 24 to 36 years old.The levels of pH,interleukin-1β(IL-1β),secretory immunoglobulin A(sIgA)and lactate dehydrogenase(LDH),bacterial population density,bacterial diversity and local immune function[interleukin 2(IL-2),interleukin 10(IL-10),interleukin 12(IL-12),γ-interferon(IFN-γ)]were compared between the two groups.Results The levels of pH(6.04±0.05)and IL-1β[(132.49±15.49)mg/L]in the vaginitis group were higher than those in the healthy group[(5.41±0.04),(83.29±12.45)mg/L],respectively,the levels of sIgA[(156.74±18.49)U/L]and LDH[(53.29±8.29)U/L]in the vaginitis group were significantly lower than those of the healthy group[(212.57±23.49)U/L,(82.35±10.42)U/L],and the difference was statistically significant(P<0.05).Flora density and diversity Grade I in the vaginitis group was[24.0%(12/50)]and GradeⅡwas[34.0%(17/50)],which was higher than that in the healthy group[10.0%(7/70),17.1%(12/70)],and GradeⅢ[42.0%(21/50)]was lower than that in healthy group[72.9%(51/70)],(P<0.05);there was no statistically significant difference in Grade IV between two groups(P<0.05).The levels of IL-2[(17.45±4.95)pg/ml],IL-10[(156.95±4.29)pg/ml],IL-12[(278.96±55.29)pg/ml],IFN-γ[(97.37±15.45)pg/ml]in the vaginitis group were higher than those in the healthy group[(11.79±2.65)pg/ml,(128.16±2.03)pg/ml,(201.46±43.27)pg/ml,(68.43±10.94)pg/ml],and the difference was statistically significant(P<0.05).Conclusion The local immune status of the vagina of patients wit

关 键 词：孕期霉菌性阴道炎 阴道微生态 局部免疫功能 辅助性T细胞1 细胞功能 

分 类 号：R711.31[医药卫生—妇产科学] R714.2[医药卫生—临床医学]