分娩方式对生殖道微生物组影响的机理学研究  

Effect of delivery way on reproductive tract microbiota

作　　者：杨星[1] 张博伦 李满超[1] 曾智 梁晓燕[1] 高琳芝 黄睿[1] Yang Xing;Zhang Bolun;Li Manchao;Zeng Zhi;Liang Xiaoyan;Gao Linzhi;Huang Rui(Reproductive Medicine Center,the Six Affiliated Hospital of Sun Yat-sen University,Guangzhou 510063,China)

机构地区：[1]中山大学附属第六医院生殖医学研究中心,广州510063

出　　处：《中华生殖与避孕杂志》2021年第11期1002-1010,共9页Chinese Journal of Reproduction and Contraception

摘　　要：目的:评价差异表达的宫颈外口和内膜组织微生物组与女性不孕的相关性。方法:纳入2019年8月至2019年12月期间于中山大学附属第六医院生殖医学研究中心助孕治疗的14名继发不孕患者进行病例对照研究,根据既往分娩方式分为剖宫产组和顺产组。剖宫产组包含9例剖宫产继发不孕患者,顺产组包含同期5例顺产后继发不孕患者,并分别对患者的宫颈和内膜进行采样分析。提取两组宫颈外口和内膜表面组织的总DNA进行16S rRNA分析,并对测序结果行生物信息学分析和统计学分析。结果:通过高通量测序方法对剖宫产宫颈组、剖宫产内膜组、顺产宫颈组和顺产内膜组进行测序,共检测到12种微生物群,其中含量最高的是菌门厚壁菌,在四组中的水平由高到低依次为顺产宫颈组、顺产内膜组、剖宫产宫颈组和剖宫产内膜组。拟杆菌门丰度在顺产组表达较高,而变形菌门在剖宫产组表达较高。菌科水平发现14个优势菌群,含量最高的菌科为乳杆菌科,在四组中的水平由高到低依次为顺产宫颈组、顺产内膜组、剖宫产宫颈组和剖宫产内膜组。进一步分析发现13个优势菌属,含量最高的菌属为乳杆菌,在四组中的水平由高到低依次为顺产宫颈组、顺产内膜组、剖宫产宫颈组和剖宫产内膜组。结论:剖宫产和顺产分娩妇女的生殖道微生物群落组成和丰度存在差异,剖宫产妇女的生殖道乳杆菌菌群丰度相比顺产妇女显著降低。本研究提示剖宫产后妇女不孕状态与子宫腔内乳杆菌等群落丰度的差异相关,提示从生殖道乳杆菌菌群丰度改善角度出发,是寻求改善不孕结局,进而提高辅助生殖成功率的新治疗策略。Objective To evaluate the correlation between the microbial flora differences of the external cervix and endometrium and female infertility.Methods It was a case-control study involving 14 patients who had delivered previously and underwent assisted reproduction treatment.Patients were divided into cesarean group(9 patients)and vaginal birth group(5 patients)according to their previous delivery method,and the patients'cervix and endometrium were analyzed separately.The total DNA of the two groups origin from external cervical and endometrial tissues were extracted for 16S rRNA analysis,and the sequencing results were further analyzed by bioinformatics and statistics.Results External cervical and endometrial tissues from each group were sequenced by high-throughput sequencing methods.Twelve kinds of microbial flora at the level of Phylum were detected.Firmicutes had the highest content,and its level in each group was as follows:vaginal birth cervix group>vaginal birth endometrium group>cesarean cervix group>cesarean endometrium group.The abundance of Bacteroidetes was higher in vaginal birth group,while the Proteobacteria was higher in cesarean group.Fourteen dominant bacterial groups were found at the level of family.Lactobacillus had the highest content and its level among four groups was as follows:vaginal birth cervix group>vaginal birth endometrium group>cesarean cervix group>cesarean endometrium group.Further analysis found 13 dominant bacteria genera,Lactobacillus had the highest content,the level among the four groups was as follows:vaginal birth cervix group>vaginal birth endometrium group>cesarean cervix group>cesarean endometrium group.Conclusion There were differences in the composition and abundance of female reproductive tract microbiota of women after cesarean delivery and vaginal birth.The abundance of genital tract lactobacillus flora of women after cesarean section was significantly lower than that of women after vaginal birth.This study revealed that the difference in the abundance of Lactobacil

关 键 词：生殖道微生物组 不孕症 高通量核苷酸测序 瘢痕子宫 

分 类 号：R711.6[医药卫生—妇产科学]