复发性流产生殖道感染病原学和蜕膜组织TLR4、MIF、bax/bcl-2表达水平及其临床意义  

Etiological characteristics of genital tract infections in recurrent spontaneous abortion patients,expressions of TLR4,MIF and bax/bcl-2 in decidual tissues and clinical significance

作　　者：李素叶 王娇 焦艳 郭丹 冀雪霞 LI Su-ye;WANG Jiao;JIAO Yan;GUO Dan;JI Xue-xia(Hengshui People's Hospital,Hengshui,Hebei 053000,China)

机构地区：[1]衡水市人民医院生殖医学科,河北衡水053000

出　　处：《中华医院感染学杂志》2024年第14期2192-2196,共5页Chinese Journal of Nosocomiology

基　　金：河北省医学科学研究重点基金资助项目(20150248)。

摘　　要：目的探讨复发性流产(RSA)生殖道感染病原学和蜕膜组织中Toll样受体4(TLR4)、巨噬细胞移动抑制因子(MIF)、细胞淋巴瘤基因-2(bcl-2)和Bcl-2相关蛋白(bax)表达水平及其临床意义.方法选取2022年4月-2023年7月衡水市人民医院RSA再次妊娠出现先兆流产患者103例为RSA组,根据生殖道感染情况分为感染组与未感染组,另选取正常早孕人流要求终止患者101例为对照组,实时荧光定量聚合酶链式反应测定蜕膜组织TLR4、MIF、bax/bcl-2 mRNA水平,Logistic回归分析RSA发生影响因素.结果103例RSA患者共有52例发生生殖道感染,感染发生率为50.49%;RSA组蜕膜组织TLR4 mRNA、bax mRNA水平高于对照组,MIF mRNA、bcl-2 mRNA水平低于对照组,bax/bcl-2值高于对照组(P<0.05);Logisitic回归分析显示生殖系统感染、内分泌异常、TLR4高表达、高bax/bcl-2值是RSA发生的危险因素,MIF高表达是防止RSA发生的保护因素;感染组蜕膜组织TLR4 mRNA、MIF mRNA、bax mRNA表达水平高于未感染组,bcl-2 mRNA表达水平低于未感染组,bax/bcl-2值高于未感染组(P<0.05).结论RSA患者蜕膜组织TLR4高表达,MIF低表达,bax/bcl-2值升高,生殖道感染可增加RSA发生风险,使患者TLR4、bar/bcl-2水平进一步升高.OBJECTIVE To explore the etiological characteristics of genital tract infections in the patients with re-current spontaneous abortion(RSA),observe the expressions of Toll-like receptor 4(TLR4),macrophage migra-tion inhibitory factor(MIF),B cell lymphoma/leukemia-2(bcl-2)and bcl-2-related proteins in decidual tissues and analyze the clinical significance.METHODS A total of 103 RSA patients who had threatened abortion for sec-ond pregnancy and were treated in Hengshui People's Hospital from Apr 2022 to Jul 2023 were assigned as the RSA group and were divided into the infection group and the no infection group according to the status of genital tract infection.Meanwhile,101 normal early pregnancy patients who required for termination of pregnancy by in-duced abortion were chosen as the control group.The levels of TLR4,MIF and bax/bcl-2 mRNA in decidual tis-sues were detected by real-time fluorescent quantitative polymerase chain reaction,and logistic regression analysis was performed for the influencing factors for RSA.RESULTS Among the 103 RSA patients,52 had genital tract infection,with the incidence of infection 50.49%.The levels of decidual tissue TLR4 mRNA and bax mRNA of the RSA group were higher than those of the control group,while the levels of MIF mRNA and bcl-2 mRNA of the RSA group were lower than those of the control group,and the ratio of bax to bcl-2 of the RSA group was higher than that of the control group(P<0.05).The result of logistic regression analysis showed that the repro-ductive system infection,cryptorrbea,high expression of TLR4 and high ratio of bax to bcl-2 were the risk fac-tors for the RSA,while the high expression of MIF was the protective factor for RSA.The expression levels of de-cidual tissue TLR4 mRNA,MIF mRNA and bax mRNA of the infection group were higher than those of the no infection group,while the expression level of bcl-2 mRNA of the infection group was lower than that of the no in-fection group,and the ratio of bax to bcl-2 of the infection group was higher than that of the

关 键 词：复发性流产 病原菌 生殖道感染 Toll样受体4 巨噬细胞移动抑制因子 细胞淋巴瘤基因-2 

分 类 号：R714.21[医药卫生—妇产科学]