阴道局部免疫状态与复发性外阴阴道念珠菌病发病的关系

Relationship between Local Immune Condition of Vagina and Recurrent Vulvovaginal Candidiasis

目的:检测人β防御素-2(HBD-2)、白细胞介素-4(IL-4)、干扰素-γ(IFN-γ)在健康女性、外阴阴道念珠菌病(VVC)及复发性外阴阴道念珠菌病(RVVC)患者阴道灌洗液中的表达水平,探讨阴道局部免疫状态与RVVC发病的关系。方法:选取对照组20例,VVC组患者22例及RVVC组患者26例,分别测定三组人群阴道pH值,并用ELISA法测定阴道灌洗液中HBD-2、IL-4、IFN-γ的表达水平。结果:①VVC组及RVVC组阴道pH值明显高于对照组(P<0.05),两组间阴道pH值之间无统计学差异;②VVC组和RVVC组HBD-2的表达水平明显高于对照组(P<0.05),RVVC组较VVC组的HBD-2的表达水平升高(P<0.05);③VVC组和RVVC组IL-4表达水平均高于对照组,RVVC组较VVC组的IL-4表达水平升高(P<0.05);④IFN-γ表达水平在三组中无统计学差异(P>0.05)。结论:阴道局部免疫状态紊乱可能与念珠菌性阴道炎发病和复发有关。

Objective：To investigate the relationship between local immune condition of vagina and the pathogenesis of recurrent vulvovaginal candidiasis. Methods：Participants of this study were divided into 3 groups： normal controls group（20 cases）,vulvovaginal candidiasis group（VVC,22 cases） and recurrent vulvovaginal candidiasis group（RVVC,26 cases）.The expression level of HBD-2、IL-4 and IFN-γ of vaginal lavage were all measured by ELISA,and the pH values of vagina were measured at the same time. Results： The pH values in VVC and RVVC groups were both higher than that in normal controls（P0.05）,but there was no significant difference between VVC and RVVC groups.The concentration of HBD-2 in vaginal lavage in RVVC and VVC groups were both higher than that in normal controls,and it was significantly higher in RVVC group than that in VVC group（P0.05）.The concentration of IL-4 in vaginal lavage in VVC and RVVC groups were both higher than that in normal controls（P0.05）,and it was significantly higher in RVVC group than that in VVC group（P0.05）.There were no significant differences in the concentration of IFN-γ in vaginal lavage among three groups（P0.05）. Conclusion：The abnormality of local immune condition of vagina might participate in the pathogenesis and the recurrence of vulvovaginal candidiasis.