阴道液中唾液酸酶活性、阴道加德纳菌及其IgA水平的相关性研究

A correlation study among sialidase activity,Gardnerella vaginalis and immunoglobulin A against Gardnerella vaginalis hemolysin in vaginal fluids from patients with bacterial vaginosis

目的探讨阴道液中唾液酸酶活性、阴道加德纳菌及抗阴道加德纳菌的溶血素(anti-Gvh)IgA水平在细菌性阴道病(BV)的相关性。方法对15例健康人和60例临床诊断为BV的患者,取阴道分泌物分别进行唾液酸酶活性和anti-Gvh IgA水平测定及阴道加德纳菌(Gv)分离培养。唾液酸酶活性利用从底物-5溴-4氯-3吲哚基-α-D-N乙酰基神经氨酸(X-Neu5Ac)转化而得到的甲氧基苯酚的纳摩尔数来表示;anti-Gvh IgA通过ELISA法测定。结果BV组Gv活菌数(6.96 log CFU/g)显著高于健康对照组(2.58 log CFU/g)(P<0.01)。BV组anti-GvhIgA(238.0±220.6)显著高于健康对照组(175.0±40.16)(P<0.01)。BV组Gv分离率(86.7%)显著高于健康对照组(33.3%)(P<0.01)。45例临床诊断为BV的患者中,其中26例Gvh IgA(+),19例Gvh IgA(-);Gvh IgA(-)组阴道液中唾液酸酶活性(5.00±1.29)显著高于Gvh IgA(+)组(1.58±1.22)(P<0.01),2组的Gv的分离率和活菌数差异却没有显著性(P>0.05)。结论BV患者阴道内高活性的唾液酸酶与低水平anti-Gvh IgA和黏膜IgA破坏程度具有关联性。

Objective To explore the correlation among sialidase activity, Gardnerella vaginalis and the antiGardnerella vaginalis hemolysin （Gvh） Immunoglobulin A （IgA） in vaginal fluids from patients with bacterial vaginosis. Methods The study population comprised of 15 healthy volunteers, 60 women with bacterial vaginosis. Bacterial vaginosis was diagnosed by clinical criteria. The vaginal fluids from patients with bacterial wiginosis were evaluated for sialidase levels and anti-Gvh IgA and cultured isolation of Gardnerella vaginalis （Gv）. Sialidase activity using 5-bromo-4-chloroindol-3- α D-N-acetylneuraminic acid （X-Neu5Ac）as the substrate, specific activity was expressed as nanomoles of methoxyphenol produced. ELISA for anti-Gvh IgA. Results The mean count of Gv was significantly higher in BV group than in the healthy counterpart （ 6. 96 log CFU/g vs 2. 58 log CFU/g） （ P 〈 0. 01 ）. The positive rate of Gv in BV patients were higher than that in healthy control group counterpart （86. 7% vs 33.3% ） （P 〈 0. 01 ）. The anti-Gvh IgA was significantly higher in BV group than in the healthy counterpart （ 238.0 ± 220. 6 vs 175.0 ± 40. 16） （ P 〈 0. 01 ）. The BV patients comprised 26 women with bacterial vaginosis that was positive for anti-Gvh IgA and 19 women with bacterial vaginosis that was negative for anti-Gvh IgA. Women having bacterial vaginosis of lucking anti-Gvh IgA had a significantly higher level of sialidase activity than BV patients who had an anti-Gvh IgA（P 〈0. 01 ）counterpart （5.00 ± 1.29 vs 1.58 ± 1.22） ; However, BV patients who had an anti-Gvh IgA group and BV patients of lacking anti-Gvh IgA were no significant difference not only the positive rate but also the count of Gv（ P 〉 0. 05 ）. Conclusion The presence of high levels of vaginal sialidase activity was associated with low anti-Gvh IgA and with mucosal IgA degradation in women with BV.