女性类风湿关节炎患者阴道支原体感染特点及药敏分析

Characteristics of intravaginal mycoplasma infection and drug sensitivity in female patients with rheumatoid arthritis

目的临床观察女性类风湿关节炎(rheumatoid arthritis,RA)患者阴道内支原体感染特点并对其药物敏感性进行分析。方法本研究共纳入246例女性RA患者(RA组)、113例女性非RA其他疾病患者(非RA组)及126例女性健康体检者(健康组)。收集研究人群的宫颈分泌物标本,对其进行支原体分离培养并分类(解脲脲原体、人型支原体等)及药物敏感性试验。结果 RA组、非RA组及健康组支原体阳性率比较差异不具有统计学意义(P=0.616);3组患者中解脲脲原体型、人型支原体型和混合型(解脲脲原体型+人型支原体型)感染的构成比具有统计学意义(P=0.021)。两两比较显示,RA组与健康组相比具有统计学差异(P<0.001),非RA组与健康组相比也具有统计学意义(P<0.001)。此外,3组支原体感染者进行12种抗生素药物敏感性试验表明,支原体对四环素、大环内酯类抗生素(强力霉素、罗红霉素、阿齐霉素、克拉霉素)的药物敏感性具有统计学差异(P<0.05)。结论女性RA患者、非RA患者及健康体检者的支原体阳性率具有相似特点,而女性RA患者、非RA患者均与健康体检者在支原体感染类型构成上存在不同,且3组支原体感染对四环素类、大环内酯类药物的药物敏感性也存在明显不同。

To investigate the features and drug sensitivity of mycoplasma from gynecological vaginal secretions of female patients with rheumatoid arthritis （RA）, total of 246 female patients with RA （RA group）, 113 female non- RA patients with other rheumatic diseases （non-RA group） and 126 female healthy subjects （control group） were included in the study. Followed by collection of cervical secretions, intravaginal mycoplasmas, including Ureaplasma urealyticum （Uu） and Mycoplasma hominis （Mh） were isolated from the samples and cultured in liquid medium. Meanwhile the drug sensitivity assay was performed. The positive rate of mycoplasma showed no significant difference among the three groups （P=0.616）. Female patients were infected mostly with Uu, Mh, Uu ＋ Mh, but the constituent ratios among the RA group, the non-RA group and the control group were statistically significant （P= 0.021）, and when compared in pairs, there were statistically differences between RA group and the control group （P〈0.001）, and also between non-RA group and control group （P〈0.001）. Twelve sorts of drug sensitivity assay for mycoplasma showed the drug sensitivities to tetracycline and macrolide antibiotics （doxycycline, roxithromycin, azithromycin, clarithromycin） were statistically significant （P〈 0.05）. In conclusion, mycoplasma infection demonstrates similar feature in the female patients with RA, patients with other rheumatic diseases and healthy volunteers. However, there were statistical differences in the types of mycoplasma and the drug sensitivity of mycoplasma to tetracycline antibiotics and macrolide antibiotics in these three groups.