硝夫太尔制霉素和甲硝唑栓对妊娠合并细菌性阴道病患者绒毛超微结构及Caspase-3表达的影响

Effect of Nifuratel nystatin and Metronidazole suppositories on villus ultrastructure and caspase-3 expression of pregnant women with bacterial vaginosis

目的探讨硝夫太尔制霉素和甲硝唑栓对妊娠合并细菌性阴道病患者的绒毛超微结构及不良妊娠结局的影响。方法将2013年4月-2015年7月在云南省第二人民医院就诊的妊娠合并细菌性阴道病患者分为A组(未用药)37例、B组(硝夫太尔制霉素)62例、C组(甲硝唑)60例,并选同期正常妊娠者为D组(正常组)60例,比较B、C两组的治疗效果,比较4组不良妊娠结局发生以及绒毛超微结构、细胞凋亡蛋白天冬氨酸特异性半胱氨酸蛋白酶3(Caspase-3)表达上的差异。结果 B、C两组的治疗总有效率及不良反应发生率比较,差异无统计学意义(P>0.05),但疾病复发率,差异有统计学意义(P<0.05),B组(1.61%)低于C组(18.33%);不良妊娠结局发生率比较,B、C、D 3组均低于A组;绒毛超微结构及Caspase-3表达比较,A、B、C3组两两比较差异具有统计学意义(P<0.05)。结论硝夫太尔制霉素在治疗妊娠合并细菌性阴道病患者时,具有较高的治疗有效率及低复发率,且有利于避免绒毛组织结构进一步损伤及细胞凋亡的发生。

Objective To investigate the effect of Nifuratel nystatin and Metronidazole suppositories on villus ultrastructure and adverse pregnancy outcomes in pregnant women with bacterial vaginosis. Methods The pregnant women with bacterial vaginosis who were admitted to our hospital from April 2013 to July 2015 were divided into group A(37 cases without medication), group B(62 cases treated with Nifuratel nystatin) and group C(60 cases treated with Metronidazole suppositories); at the same time 60 normal pregnant women were enrolled into group D(normal group). The treatment effect was compared between the groups B and C. The adverse pregnancy outcomes,villus ultrastructure and expression of apoptosis protein caspase-3 were compared among the four groups. Results There was no significant difference in the total effective rate or incidence of side effects between the groups B and C(P > 0.05), but the recurrence rate in the group B(1.61%) was lower than that in the group C(18.33%, P < 0.05). The incidences of adverse pregnancy outcomes in the groups B, C and D were lower than that in the group A(P < 0.05).There were significant differences in the villous ultrastructure and caspase-3 expression among the groups A, B and C(P < 0.05). Conclusions Nifuratel nystatin has high efficiency and a low recurrence rate in the treatment of bacterial vaginosis in pregnant women, and helps to avoid further damage to villus structure and the occurrence of apoptosis.