蛋白激酶C抑制剂对念珠菌性阴道炎患者Th1/Th2免疫偏移的作用

Effect of protein kinase C inhibitor on Th1/Th2 immune deviation in patients with Candidal vaginitis

目的观察蛋白激酶C抑制剂对念珠菌性阴道炎患者Th1/Th2免疫偏移的作用。方法选择2014年1月1日至2015年1月1日达州市中西医结合医院收治的念珠菌性阴道炎患者共134例,按随机分组原则分为观察组65例和对照组69例。对照组进行单纯抗真菌治疗,观察组进行蛋白激酶C抑制剂联合抗真菌治疗。治疗前测定患者血清白介素12(IL-12)及干扰素γ(IFN-γ)水平。治疗结束后7 d、14 d、1个月和3个月各随访一次,3个月后再次测定血清IL-12及IFN-γ水平,以及取阴道分泌物,采用10%氢氧化钾溶液湿片检查是否还存在假菌丝或孢子。结果两组患者治疗前IL-12及IFN-γ水平比较差异均无统计学意义(P>0.05);治疗后,观察组患者的IL-12及IFN-γ水平比对照组明显降低,差异具有统计学意义(P<0.05);经过3个月的治疗与随访结束后,观察组治愈53例,好转8例,总有效率为93.85%,对照组治愈35例,好转16例,总有效率为73.91%,两组比较差异具有统计学意义(P<0.05)。结论蛋白激酶C抑制剂可明显降低念珠菌性阴道炎患者IL-12及IFN-γ水平,纠正Th1/Th2免疫偏移,可提高治愈率。

Objective To investigate the effect of protein kinase C inhibitors on Th1/Th2 immune deviation in patients with Candidal vaginitis. Methods A total of 134 patients with Candidal vaginitis in our hospital from January 1, 2014 to January 1, 2015 were selected. According to the random grouping, they were divided into protein kinase C in-hibitors group （observation group, n=65） and control group （n=69）. The control group was treated with simple antifungal therapy, and the observation group was treated with protein kinase C inhibitors combined with antifungal therapy. Serum interleukin 12 （IL-12） and interferon gamma （IFN-γ） levels were measured before treatment. The patients were fol-lowed up at 7 d, 14 d, 1 month and 3 months after treatment. Serum IL-12 and IFN-γ levels were measured again 3 months later, and vaginal secretions were collected. 10%potassium hydroxide solution was used to check the presence of pseudohypha or spores. Results The IL-12 and IFN-γ levels were not significantly different between the two groups before treatment （P〉0.05）. After treatment, the IL-12 and IFN-γlevels in the observation group were significant-ly lower than those in the control group （P〈0.05）. After 3 months of treatment and follow-up, 53 patients were cured and 8 patients were improved in observation group, versus 35 patients and 16 patients in the control group. The overall effec-tive rate in the observation group was significantly higher than that in the control group （93.85%vs 73.91%, P〈0.05）. Conclusion Protein kinase C inhibitor can significantly reduce the levels of IL-12 and IFN-γin patients with Candi-dal vaginitis, and correct the Th1/Th2 immune deviation, and thus improve the cure rate.