妊娠期再发性念珠菌性阴道炎患者的阴道菌群多样性研究  

Diversity of vaginal flora in pregnant women with recurrent vaginal candidiasis

作　　者：唐莉[1] 隗伏冰[1] 隗洪进[1] 刘珮瑜[1] 伞翠平[1] 钟文彬[1] 刘玉华[1] 郭海珊 TANG Li;YU Fubing;YU Hongjin;LIU Peiyu;SAN Cuiping;ZHONG Wenbin;LIU Yuhua;GUO Haishan(Department of Gynecology,Dongguan City Maternal and Child Health Hospital,Dongguan,Guangdong,China,523000)

机构地区：[1]东莞市妇幼保健院妇科,广东东莞523000

出　　处：《分子诊断与治疗杂志》2022年第4期601-605,共5页Journal of Molecular Diagnostics and Therapy

基　　金：东莞市社会科技发展项目(重点)(2018507150071620);中国疾病预防控制中心妇幼保健中心“2017年度合生元母婴营养与健康研究项目”(2017FYH010)。

摘　　要：目的分析妊娠期外阴阴道假丝酵母菌病(VVC)患者治疗前后阴道菌群结构及其变化情况,探讨妊娠期VVC再发机理。方法选取2018年11月至2019年8月在东莞市妇幼保健院就诊的妊娠期VVC患者36例和健康孕妇20例,动态采集3个时间点的阴道分泌物,并根据阴道分泌物镜检结果分为未再发组、再发组、持续阳性组。所有样本做16S rDNAV3区高通量测序,比较各组之间阴道菌群差异。结果不同分组及采样点之间细菌Alpha多样性比较差异无统计学意义(P>0.05)。共发现11个门类的细菌,以厚壁菌门、放线菌门、拟杆菌门为主。共发现132个属类的细菌,其中以乳杆菌属、双岐杆菌属、普雷沃菌属、链球菌属和小杆菌属为主。主成分分析可将样本分两类,第一类以厚壁菌门为主要优势菌,第二类以放线菌门为主要优势菌。与健康孕妇对比分析,持续感染组双歧杆菌属的丰度从5%下降到0.5%,再发组普雷沃菌属丰度从1.5%下降到0.4%,再发阶段下降显著(P<0.05)。健康孕妇组以卷曲乳杆菌为优势菌,其他三组均以惰性乳杆菌为优势菌。结论阴道细菌中除有大量乳酸杆菌外,还存在双岐杆菌、普雷沃菌等差异菌属,这些细菌丰度的改变可能与VVC的发生、发展以及预后相关。Objective To analyze the vaginal flora and its changes in patients with vulvovaginal candidiasis(VVC)during pregnancy before and after treatment,in order to explore the mechanism of VVC recurrence during pregnancy.Methods 36 VVC patients and 20 healthy pregnant women were selected in Dongguan City Maternal and Child Health Hospital from November 2018 to August 2019.The vaginal discharge were collected dynamically at three time points and were divided into the non⁃recurrence group,the recurrence group and the persistent positive group according to the experimental results.NGS of 16S rDNA V3 region was used to compare the differences of vaginal flora among groups.Results There was no significant difference in Alpha diversity among different groups and sampling sites(P>0.05).A total of 11 species of bacteria were found,mainly Firmicutes,Actinobacteria and Bacteroidetes.A total of 132 Genera of bacteria were found,among which Lactobacillus,Bifidobacterium,Prevotella,Streptococcus and Dialister.Principal component analysis can divide the samples into two categories,the first type has Firmicutes as the main dominant bacteria,and the second type has Actinobacteria as the main dominant bacteria..Compared with healthy pregnant women,the abundance of Bifidobacterium in the persistent infection group decreased from 5%to 0.5%,and the abundance of Prevotella in the recurrence group decreased from 1.5%to 0.4%,with a significant decrease in the recurrence stage(P<0.05).Lactobacillus crispatus was the dominant bacteria in the healthy pregnant women group,and Lactobacillus inerts was the dominant bacteria in the other three groups.Conclusion In addition to a large number of lactobacilli in vaginal bacteria,there are also differential bacteria such as Bifidobacterium and Prevotella.The changes in the abundance of these bacteria may be related to the occurrence,development and prognosis of VVC.

关 键 词：念珠菌性阴道炎 阴道菌群 高通量测序 妊娠 

分 类 号：R711.31[医药卫生—妇产科学]