宫腔粘连合并支原体感染宫颈TLRs信号通路与T淋巴细胞亚群及炎症因子水平变化  

Analysis of changes of cervical TLRs signaling pathways,T lymphocyte subsets and inflammatory factors in patients with intrauterine adhesions complicated with mycoplasma infection

作　　者：林丽慧 闫志强 任青 简开乾 曾思衡 LIN Li-hui;YAN Zhi-qiang;REN Qing;JIAN Kai-gan;ZENG Si-heng(Western Hainan Central Hospital,Danzhou,Hainan 571700,China;不详)

机构地区：[1]海南西部中心医院妇科,海南儋州571700 [2]上海市第九人民医院妇科,上海200000 [3]海南西部中心医院检验科,海南儋州571700

出　　处：《中华医院感染学杂志》2023年第15期2343-2347,共5页Chinese Journal of Nosocomiology

基　　金：海南省科研基金资助项目(2020S02101)。

摘　　要：目的 研究宫腔粘连(IUA)合并支原体感染患者宫颈Toll样受体(TLRs)信号通路、T淋巴细胞亚群及炎症因子水平变化。方法 以2019年3月-2022年3月海南西部中心医院IUA合并支原体感染患者76例(研究组)、IUA未合并感染患者71例(未感染组)和体检女性74名(健康组)为样本进行研究,收集三组基本信息并于月经结束第1天采集宫颈分泌物,分别检测TLRs、T淋巴细胞以及炎症因子白细胞介素(IL)-1β、IL-6和肿瘤坏死因子-α(TNF-α)等指标表达水平。结果 研究组宫颈分泌物TLR1、TLR2、TLR4和TLR6表达水平高于未感染组和健康组(P<0.05),且未感染组宫颈分泌物TLR4表达水平高于健康组(P<0.05);研究组宫颈分泌物CD3+、CD4+和CD4+/CD8+比值低于未感染组和健康组(P<0.05);研究组宫颈分泌物IL-1β、IL-6和TNF-α水平高于未感染组和健康组(P<0.05),且未感染组各项指标高于健康组(P<0.05);IUA合并支原体感染患者宫颈分泌物中TLR2和TLR4与IL-1β、IL-6和TNF-α均呈正相关性(P<0.05)。结论 生殖道支原体感染合并IUA患者宫颈分泌物中TLRs和炎症因子表达水平升高,CD4+/CD8+比值降低,且TLRs信号通路激活可能在炎症反应过程发挥重要作用。OBJECTIVE To study the changes of cervical toll-like receptors(TLRs)signaling pathways,T lymphocyte subsets and levels of inflammatory factors in patients with intrauterine adhesions(IUA)complicated with mycoplasma infection.METHODS Total of 76 patients with IUA and mycoplasma infection(study group),71 IUA patients without infection(non-infected group)and 74 female people under physical examination(healthy group)in Western Hainan Central Hospital between Mar 2019 and Mar 2022 were enrolled.The basic information of the three groups were collected,and cervical secretions were obtained on the lst day after the end of menstruation,and the expression levels of TLRs,T lymphocytes and inflammatory factors of interleukin(IL)-1β,IL-6 and tumor necrosis factorα(TNF-α)were detected.RESULTS The expression levels of TLR1,TLR2,TLR4 and TLR6 in cervical secretions of the study group were higher than those of the non-infected group and healthy group(P<0.05)and the expression level of TLR4 in cervical secretions of the non-infected group was higher than that of the healthy group(P<0.05).CD_(3)^(+)cells,CD_(4)^(+)cells and CD_(4)^(+)/CD_(8)^(+)ratio in the cervical secretion of the study group were lower than those of the non-infected group and healthy group(P<0.05).The levels of IL-1β,IL-6 and TNF-αin cervical secretion in the study group were higher when comparing with those in the non-infected group and healthy group(P<0.05),and the indicators in the non-infected group were higher than those in the healthy group(P<0.05).TLR2 and TLR4 levels were positively correlated with IL-1β,IL-6 and TNF-αlevels in cervical secretions of patients with IUA and mycoplasma infection(P<0.05).CONCLUSION The expression levels of TLRs and inflammatory factors in cervical secretions increase when the ratio of CD_(4)^(+)/CD_(8)^(+)decreases among patients with mycoplasma genital tract infection and IUA.Activation of TLRs signaling pathway may play an important role in inflammatory response.

关 键 词：宫腔粘连 支原体感染 TOLL样受体 细胞免疫 炎症因子 

分 类 号：R711.3[医药卫生—妇产科学]