乳酸杆菌治疗对妊娠期宫内感染及Th17/Treg细胞因子的影响

Influence of Lactobacillus on intrauterine infection and Th17/Treg cytokine during pregnancy

目的探讨乳酸杆菌治疗对妊娠期发生宫内感染及血清辅助性T细胞17/调节性T细胞(Th17/Treg)细胞因子的影响。方法选取2016年4月-2017年5月决定在石家庄市第四医院分娩的妊娠中期女性92例,随机分为治疗组和对照组。治疗组给予乳酸菌阴道胶囊干预,而对照组不做任何干预,比较干预后两组孕妇阴道分泌物清洁度及干预前后乳酸杆菌含量、Th17/Treg细胞比例及血清相关细胞因子水平变化、宫内感染的发生率、孕妇破膜情况、新生儿阿氏(Apgar)评分情况。结果治疗组宫内感染率及新生儿Apgar评分中≤7分的比例低于对照组(P<0.05)。而人工破膜和足月胎膜早破的情况比较无统计学差异。干预前,两组孕妇阴道分泌物清洁度及乳酸杆菌含量、Th17/Treg细胞比例、白介素-17(IL-17)、白介素-23(IL-23)、干扰素-γ(INF-γ)及肿瘤坏死因子-α(TNF-α)水平比较无统计学差异。而干预后,治疗组孕妇各指标均改善(P<0.05),对照组各指标均无明显变化。结论妊娠期通过乳酸杆菌干预可改善孕妇的阴道清洁度,降低宫内感染的发生率,同时能够有效改善Th17/Treg细胞比例及相关细胞因子水平。

OBJECTIVE To explore the influence of Lactobacillus on intrauterine infection and serum helper T cell 17/regulatory T cell(Th17/Treg)cytokines during pregnancy.METHODS From Apr 2016 to May 2017,a total of 92 pregnant women with second trimester of pregnancy who determined to give birth in Shijiazhuang Fourth Hospital were enrolled in the study and randomly divided into the treatment group and the control group.The treatment group was treated with vaginal administration of lactic acid bacteria capsule,while the control group was not treated with any intervention.The cleanliness of vaginal secretions was compared between the two groups of pregnant women after the intervention,the levels of Lactobacillus,Th17/Treg and serum cytokines were compared before and after the intervention,the incidence of intrauterine infection,status of rupture of membranes and newborn Agar score were observed and compared.RESULTS The incidence rate of intrauterine infection of the treatment group was significantly lower than that of the control group,the percentage of the pregnant women whose newborn Apgar score was no more than 7 points was significantly lower in the treatment group than in the control group(P<0.05).There was no significant difference in the artificial rupture of fetal membranes or full-term rupture of membranes.There were no significant differences in the cleanliness of vaginal secretions,Lactobacillus level,Th17/Treg,interleukin-17(IL-17)level,interleukin-23(IL-23)level,interferon-gamma(INF-γ)level and tumor necrosis factor-alpha(TNF-α)level between the two groups of pregnant women before the intervention,while the above indexes of the treatment group were significantly improved after the intervention(P<0.05),they did not change significantly in the control group.CONCLUSION The vaginal administration of Lactobacillus may improve the vaginal cleanliness of the pregnant women,reduce the incidence of intrauterine infection and effectively improve the Th17/Treg as well as the levels of cytokines.