反复种植失败患者阴道菌群特征研究  

Study on the Vaginal Microbiota in Patients with Repeated Implantation Failure

作　　者：张荣雪 王苗苗[1] 贾媛媛 薛惠英[1] ZHANG Rong-xue;WANG Miao-miao;JIA Yuan-yuan;XUE Hui-ying(Department of Reproductive Medicine,Huai'an Maternal and Child Health Care Hospital,Huai'an 223002,Jiangsu Province,China)

机构地区：[1]江苏省淮安市妇幼保健院生殖医学科,223002

出　　处：《国际生殖健康／计划生育杂志》2024年第2期89-94,共6页Journal of International Reproductive Health/Family Planning

基　　金：淮安市自然科学研究计划(HAB202128);江苏省妇幼健康科研项目(F202163)。

摘　　要：目的:探讨反复种植失败(repeated implantation failure,RIF)患者的阴道菌群特征。方法:纳入49例接受冻融胚胎移植(frozen-thawed embryo transfer,FET)患者。其中观察组患者(n=29)有RIF病史且本次FET周期妊娠失败;对照组患者(n=20)首次行FET且成功妊娠。2组均采取人工周期准备内膜、移植第5天优质囊胚。于FET日收集患者阴道分泌物,通过16S rRNA测序对2组阴道菌群多样性、群落组成以及差异菌属进行分析。用受试者工作特征(receiver operating characteristic,ROC)曲线评估阴道乳杆菌属丰度诊断RIF的效能。结果:α多样性分析显示,观察组阴道菌群多样性(Shannon指数:P=0.0498)和丰富度(Chao指数:P=0.0471)均显著高于对照组。β多样性分析显示,2组阴道菌群结构差异有统计学意义(P=0.016)。在属水平上,2组阴道的优势菌均为乳杆菌属,与对照组相比,观察组乳杆菌属丰度显著降低,而不动杆菌属和假单胞菌属丰度显著增加(LDA>3,P<0.05)。阴道乳杆菌属丰度诊断RIF的最佳截断值为70%,曲线下面积(area under curve,AUC)为0.77。结论:RIF患者阴道菌群显示差异,以乳杆菌属丰度降低为主要特征。阴道乳杆菌属低丰度可能与RIF相关。Objective:To explore the characteristics of vaginal microbiota in patients with repeated implantation failure(RIF).Methods:A total of 49 patients undergoing the frozen-thawed embryo transfer(FET)cycles were recruited.In the observation group,patients(n=29)with a history of RIF have failed pregnancy during the FET cycles.In the control group,patients(n=20)underwent the FET for the first time and achieved clinical pregnancy.In both groups,artificial hormone cycles were performed,and the top-quality blastocysts cultured on Day 5 were tranferred.Vaginal samples were collected on the FET day.Microbial diversity,microbial community composition and differential bacterial genera between the two groups were analyzed by 16S rRNA sequencing.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of the abundance of Lactobacillus for RIF.Results:The α diversity analysis showed that the microbial diversity(Shannon:P=0.0498)and richness(Chao:P=0.0471)of the observation group were significantly higher than those of the control group.Theβdiversity analysis showed that there was significant difference in the vaginal microbial community composition between the two groups(P=0.016).At the genus level,Lactobacillus was dominant in both groups.The abundance of Lactobacillus of the observation group was significantly lower than that of the control group,while the abundances of Acinetobacter and Pseudomonas of the observation group were significantly higher than those of the control group(LDA>3,P<0.05).The optimal cutoff value for diagnosing RIF with the abundance of Lactobacillus was 70%,and the area under curve(AUC)was 0.77.Conclusions:Vaginal microbiota was showed differences in RIF patients,including the decreased abundances of Lactobacillus.The low abundance of vaginal Lactobacillus may be related with the pathogenesis of RIF.

关 键 词：反复种植失败 阴道 阴道菌群 16S rRNA测序 高通量测序 

分 类 号：R714.8[医药卫生—妇产科学]