孕期阴道微生态变化对先兆早产孕妇不良妊娠结局的预测价值  

Relationship between vaginal microecological changes during pregnancy and adverse pregnancy outcomes in pregnant women with threatened preterm labor

作　　者：巫兴聪 刘霞 WU Xing-cong;LIU Xia(Department of Obstetrics and Gynecology,Panzhihua Combined Hospital of Traditional Chinese and Western Medicine,Panzhihua 617099,Sichuan,China)

机构地区：[1]攀枝花市中西医结合医院妇产科,四川攀枝花617099

出　　处：《川北医学院学报》2025年第2期253-256,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨孕期阴道微生态变化对先兆早产孕妇不良妊娠结局的预测价值。方法:选取208例先兆早产孕妇为研究对象,按照妊娠结局不同分为早产组(n=75)与足月组(n=133)。比较两组孕妇阴道pH值、阴道分泌物微生物菌群相对丰度及相关生化指标[唾液酸苷酶活性(SNA)、过氧化氢浓度(H_(2)O_(2))及白细胞酯酶(LE)],采用受试者工作特征(ROC)曲线分析阴道微生态菌群及相关生化指标对不良妊娠结局的预测价值。结果:早产组孕妇乳酸杆菌属相对丰度低于足月组(P<0.05);阴道pH值、加德纳菌属相对丰度及H_(2)O_(2)、LE阳性率高于足月组(P<0.05)。ROC曲线分析显示,阴道pH值、乳酸杆菌属、加德纳菌属预测不良妊娠结局发生的曲线下面积(AUC)分别为0.712、0.931、0.921,截断值分别为4.14、59.95%、17.7%。结论:先兆早产孕妇不良妊娠结局与阴道微生态变化密切相关,乳酸杆菌属相对丰度<59.95%、加德纳菌属相对丰度>17.7%、pH值>4.14时提示孕妇存在先兆早产不良妊娠结局的风险。Objective:To explore the predictive value of changes in vaginal microecology during pregnancy on adverse pregnancy outcomes in pregnant women with threatened preterm labor.Methods:The clinical data of 208 women with threatened preterm labor were retrospectively analyzed.According to the pregnancy outcomes,the pregnant women were divided into preterm group(n=75)and full-term group(n=133).The pH value of vaginal secretion,relative abundance of microbial flora and related biochemical indicators[hydrogen peroxide concentration(H_(2)O_(2)),sialidase activity(SNA)and leukocyte esterase(LE)]were detected and compared between the two groups.Receiver operating characteristic(ROC)curve were used to analyze the predictive value of vaginal microecological flora and related biochemical indicators on adverse pregnancy outcomes.Results:Compared with full-term group,the relative abundance of Lactobacillus in preterm group was lower(P<0.05)while the pH value,relative abundances of Genus Gardnerella and positive rates of H_(2)O_(2) and LE were higher(P<0.05).ROC curve analysis showed that the area under the curve(AUC)for predicting adverse pregnancy outcomes for pH value,Lactobacilli,and Genus Gardnerella was 0.712,0.931,and 0.921,with cutoff values of 4.14,59.95%,and 17.7%,respectively.Conclusion:The adverse pregnancy outcomes of pregnant women with threatened preterm labor are closely related to the changes of vaginal microecology.The relative abundance of Lactobacillus is lower than 59.95%,relative abundances of Genus Gardnerella is higher than 17.7%,pH value is higher than 4.14,suggesting that pregnant women have the risk of adverse pregnancy outcomes of threatened preterm labor.

关 键 词：病因学 早产 妊娠 阴道微生态 生化指标 

分 类 号：R714[医药卫生—妇产科学]