放置IUD术后生殖道感染发生及阴道灌洗液炎症因子水平

Study on the occurrence of genital tract infection and the level of inflammatory factors in vaginal lavage fluid after IUD inserted

目的:探讨放置宫内节育器(IUD)术后生殖道感染发生及阴道灌洗液白细胞介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)水平。方法:选取2018年1月—2019年3月本院行IUD放置术女性454例,随访术后3个月生殖道感染发生情况,检测阴道灌洗液IL-4、TNF-α和IFN-γ水平。结果:454例中有67例(14.5%)发生生殖道感染;感染组放置含铜IUD比例(56.7%)高于未感染组(41.6%),阴道灌洗液IL-4、TNF-α和IFN-γ水平(132.26±20.00pg/ml、5.10±1.12g/L、240.14±31.33pg/ml)高于未感染组(101.16±27.76 pg/ml、2.03±0.68 g/L、200.50±30.01 pg/ml),其中盆腔炎者高于宫颈炎和细菌性阴道病者(均P<0.05);67例中共分离出210株病原菌,其中大肠埃希菌占比最高(65株,31.0%)。结论:放置IUD术后有一定比例发生生殖道感染,与IUD类型可能有一定关系,其中盆腔炎患者阴道灌洗液IL-4、TNF-α和IFN-γ升高,大肠埃希菌为主要病原菌。

Objective:To investigate the incidence of genital tract infection after intrauterine device(IUD)inserted,and to study the levels of interleukin-4(IL-4),tumor necrosis factor(TNF-α),interferon-(IFN-γ)in vaginal lavage fluid.Methods:454 women who underwent IUD inserted from January 2018 to March 2019 were selected in this study and were followed up for 3 months.The incidence of genital tract infection was observed,and the levels of IL-4,TNF-αand IFN-γin vaginal lavage fluid were detected.Results:Among the 454 women,67(14.5%)women had genital tract infection.The proportion of copper-bearing IUD inserted(56.7%)of women with genital tract infection was significant higher than that of women without genital tract infection(P<0.05).The levels of IL-4(132.26±20.00pg/ml),TNF-α(5.10±1.12g/L),and IFN-γ(240.14±31.33pg/ml)in vaginal lavage fluid of women with genital tract infection were significant higher than those(101.16±27.76 pg/ml,2.03±0.68 g/L,and 200.50±30.01 pg/ml)of women without genital tract infection,and which of women with pelvic inflammation were significant higher than those of women with cervicitis and bacterial vaginosis(P<0.05).210 pathogenic bacteria were isolated from 67 women with genital tract infection,of which,65(31.0%)pathogenic bacteria was escherichia coli and it was the most.Conclusion:The genital tract infection after IUD inserted may occurrence,which may be relation to IUD type.The levels of IL-4,TNF-αand IFN-γin vaginal lavage fluid of women with pelvic inflammation have increased,and escherichia coli is one of the main pathogens.