感染性早产产妇阴道内菌群变化与炎症因子、蛋白酶表达水平的相关性  

The relationship between the changes of bacterial flora in vagina and the contents of serum inflammatory factors and the expression of placental protease

作　　者：王彩丽[1] 于鹤[1] 刘莉[1] 杨小风 WANG Cai-li;YU He;LIU Li;YANG Xiao-feng(Department of Obstetrics and Gynecology,Zhoukou Central Hospital,Zhoukou,Henan 466000;Department of Obstetrics and Gynecology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]周口市中心医院妇产科,河南周口466000 [2]郑州大学附属郑州中心医院妇产科,河南郑州450000

出　　处：《热带医学杂志》2021年第3期344-347,351,共5页Journal of Tropical Medicine

基　　金：河南省医学科技攻关计划项目(2018020801)。

摘　　要：目的观察感染性早产产妇阴道内菌群变化与血清炎症因子含量、胎盘蛋白酶表达水平的相关性。方法选择2015年3月-2019年5月期间在周口市中心医院分娩的早产产妇,根据胎盘病理检查分为合并绒毛膜羊膜炎的65例感染性早产产妇(感染组)、不合并绒毛膜羊膜炎的85例非感染性早产产妇(非感染组);另取同期在本院分娩的100名足月健康产妇作为对照组。检测阴道分泌物内菌群变化、血清中炎症因子[肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)、白介素-6(IL-6)、单核细胞趋化蛋白-1(MCP-1)]的含量、胎盘中蛋白酶[基质金属蛋白酶2(MMP2)、MMP3、MMP9]的表达量。结果感染组产妇阴道微生态失调的比例、血清中TNF-α、HMGB1、IL-6、MCP-1的含量、胎盘中MMP2、MMP3、MMP9的表达量分别为44.62%、(74.94±12.58)pg/mL、(7.12±1.42)ng/mL、(148.79±32.52)pg/mL、(23.41±6.52)pg/mL、(1.21±0.34)、(1.09±0.28)、(0.98±0.24),均明显高于非感染组和对照组,差异有统计学意义(P<0.05);感染组中阴道微生态失调产妇血清中TNF-α、HMGB1、IL-6、MCP-1的含量、胎盘中MMP2、MMP3、MMP9的表达量均明显高于阴道微生态正常产妇,差异有统计学意义(P<0.05)。结论感染性早产产妇存在阴道内微生态失衡,且微生态失衡与炎症因子分泌及蛋白酶表达增加有关。Objective To observe the correlation between the changes of bacterial flora in vagina and the contents of serum inflammatory factors,the expression of placental proteinase.Methods The preterm women who delivered in Zhoukou Central Hospital from March 2015 to May 2019 were selected and divided into infective preterm women with chorioamnionitis(infective group,n=65)and non infective preterm women without chorioamnionitis(non-infective group,n=85)according to the placental pathological examination.The healthy full-term women who delivered in our hospital at the same time were selected as the control group(n=100).The changes of flora in vaginal secretions,the contents of serum inflammatory cytokines[tumor necrosis factor-α(TNF-α),high mobility group protein B1(HMGB1),interleukin-6(IL-6),monocyte chemoattractant protein-1(MCP-1)]and the expression of placental proteinases[matrix metalloproteinase 2(MMP2),MMP3,MMP9]were measured.Results The proportion of vaginal microecological disorder,the contents of TNF-α,HMGB1,IL-6,MCP-1 in serum,the expression of MMP2,MMP3 and MMP9 in placenta of infective group[44.62%,(74.94±12.58)pg/mL,(7.12±1.42)ng/mL,(148.79±32.52)pg/mL,(23.41±6.52)pg/mL,(1.21±0.34),(1.09±0.28),(0.98±0.24)]were significantly higher than those of non-infective group and control group(P<0.05);the contents of TNF-α,HMGB1,IL-6,MCP-1 in serum,the expression of MMP2,MMP3 and MMP9 in placenta of parturient woman with vaginal microecology disorder were significantly higher than those with normal vaginal microecology in infective group(P<0.05).Conclusions The imbalance of microecology in vagina was related to the occurrence of infective preterm delivery.The possible mechanism could be the increase in secretion of inflammatory factors and the expression of protease.

关 键 词：感染性早产 阴道微生态 炎症因子 蛋白酶 

分 类 号：R714.21[医药卫生—妇产科学]