阴道微生态菌群、生育指数与子宫内膜异位症患者卵巢储备功能的相关性  

Correlation between vaginal microbiota,fertility index,and ovarian reserve function in patients with endometriosis

作　　者：王树香 苗金田[2] WANG Shuxiang;MIAO Jintian(Department of gynaecology,Harbin Red Cross Center Hospital,Harbin 150000,China)

机构地区：[1]黑龙江省哈尔滨市红十字中心医院妇科,150000 [2]哈尔滨医科大学附属第一医院群力院区妇科病房

出　　处：《中国煤炭工业医学杂志》2024年第6期569-574,共6页Chinese Journal of Coal Industry Medicine

基　　金：黑龙江省卫生健康委科研课题(编号:20230505010184);黑龙江省省属高等学校基本科研业务费项目(编号:2022-KYYWF-0308)

摘　　要：目的 本研究旨在检测子宫内膜异位症患者阴道微生态菌群、生育指数与卵巢储备功能并分析三者之间的相关性。方法 选取黑龙江省哈尔滨市红十字中心医院于2022年1月—2023年12月收治的子宫内膜异位症者120例,作为病例组;另选取非卵巢巧克力囊肿的卵巢囊肿手术患者50例,作为对照组。通过16S rRNA细菌检测技术检测阴道微生态菌群,通过生育指数(EFI)评分评估生育指数,通过酶联免疫吸附(ELISA)法检测抗苗勒管激素(AMH)水平,电化学发光法检测促黄体生成素(LH)、促卵泡激素(FSH)、雌二醇(E2)水平,卵巢储备功能评分检测卵巢储备功能。结果 两组研究对象年龄、体质量指数、不孕情况、月经周期、月经初潮年龄、痛经、怀孕史、饮酒、吸烟、流产史比较,差异均无统计学意义(P<0.05)。与对照组比较,病例组研究对象革兰阴性小杆菌、革兰阴性球菌、乳酸菌菌群密度水平较低,革兰阳性菌肠杆菌水平较高,差异有统计学意义(P<0.05)。与对照组比较,病例组EFI评分较低,差异有统计学意义(P<0.05)。与对照组比较,病例组AMH水平较低,卵巢储备功能评分较高(t=16.149、18.258,P<0.05),两组研究对象LH、FSH、E2水平比较,差异无统计学意义(P<0.05)。革兰阴性小杆菌、革兰阴性球菌、乳酸菌菌群密度、EFI评分与AMH呈正相关(r=0.622、0.611、0.610、0.636,P<0.05),与卵巢储备功能评分呈负相关(r=-0.599、-0.596、-0.601、-0.512,P<0.05),革兰阳性菌肠杆菌菌群密度与AMH呈负相关(r=-0.591,P<0.05),与卵巢储备功能评分呈正相关(r=0.620,P<0.05);革兰阴性小杆菌、革兰阴性球菌、革兰阳性菌肠杆菌、乳酸菌菌群密度与LH、FSH、E2无明显相关性(P<0.05)。结论 阴道微生态菌群密度、生育指数与卵巢储备功能指标显著相关,临床可采用阴道微生态菌群、生育指数评估卵巢储备功能。Objective The vaginal microflora,fertility index and ovarian reserve function of patients with endometriosis were detected and their correlation was analyzed.Methods A total of 120 patients with endometriosis admitted to the Red Cross Central Hospital of Harbin,Heilongjiang Province from January 2022 to December 2023 were selected as the case group by representative sample method.In addition,50 patients with ovarian cyst without chocolate cyst were selected as control group.Vaginal microflora was detected by 16S rRNA bacterial detection technology,and fertility index(EFI)score was used to evaluate fertility index.The levels of anti-mullerian Hormone(AMH)were detected by enzyme-linked immunosorbent assay(ELISA).The levels of luteinizing hormone(LH),follicle stimulating hormone(FSH)and estradiol(E2)were measured by electrochemiluminescence,and ovarian reserve function score was used to detect ovarian reserve function.Results There was no significant difference in age,body mass index,infertility,menstrual cycle,menarche age,dysmenorrhea,pregnancy history,drinking,smoking and abortion history between the two groups(P>0.05).Compared with the control group,the population density levels of gram-negative microbacillus,gram-negative coccus and lactic acid bacteria in case group were lower,and the level of gram-positive enterobacter was higher,with statistical significance(t=69.170,32.984,82.705,155.902,P<0.05).Compared with control group,EFI score in case group was lower,and the difference was statistically significant(t=16.128,P<0.05).Compared with the control group,the level of anti-Mullerian hormone(AMH)in the case group was lower,and the score of ovarian reserve function was higher(t=16.149,18.258,P<0.05).The levels of luteinizing hormone(LH),folliclestimulating hormone(FSH)and estradiol(E2)between the two groups were significantly different(P>0.05).The population density of Gram-negative microbacillus,gram-negative coccus,lactic acid bacteria and EFI score were positively correlated with AMH(r=0.622,0.611,0.610,0.636

关 键 词：阴道微生态菌群 生育指数 子宫内膜异位症 卵巢储备功能 相关性 

分 类 号：R711.71[医药卫生—妇产科学]