育龄期女性解脲支原体感染后阴道微生态和Th17细胞及相关炎性因子的变化

Changes of vaginal microecology,Th17 cell and related cytokines in women of childbearing age after Ureaplasma urealyticum infection

目的研究育龄期女性解脲支原体(UU)感染后阴道微生态变化及其宫颈Th17细胞免疫及其炎性因子的关系。方法研究对象来源自我院进行检测的育龄期女性,年龄为(24~45)岁。取女性宫颈分泌物进行微生物培养检测并阴道微生态分析,流式细胞术检测Th17细胞数量,ELISA检测炎性相关细胞因子的浓度。结果对照组中检测到76例UU阳性患者,阳性率38.0%;观察组155例UU阳性患者,阳性率77.5%(χ^(2)=63.946,P<0.001)。血清型分析发现UU血清型1、血清型2、血清型6、血清型9和混合型在观察组的患者数量明显高于和对照组,未能分型则没有明显差异。Th17细胞及分泌的相关细胞因子比较发现UU检测阳性患者IL-4、IL-17以及TGF-β的浓度明显高于阴性患者(P<0.001),IL-10和IL-6未发现明显差别。最后,阴道微生态分析发现UU阳性患者的菌群多样性、菌群密度和阴道酸性正常的比例明显低于阴性患者,而微生态失调分析发现UU阳性患者比例明显高于阴性患者(P<0.05)。结论育龄期女性UU感染会使阴道微生态发生变化,其宫颈Th17细胞及其炎性因子明显上升。说明育龄期女性UU感染会出现炎性反应。导致宫颈疾病的发生,应该密切关注。

Objective To observe the vaginal microecological changes and relationship between cervical Th17 cell immunity and inflammatory factors in women of childbearing age after Ureaplasma urealyticum(UU)infection. Methods The subjects were women of childbearing age(aged 24 to 45 years)who were tested in our hospital. The specimens of cervical secretions were collected for microbial culturing and vaginal microecological analysis;flow cytometry was used to detect the number of Th17 cells,and ELISA to detect the concentration of inflammatory-related cytokines. Results Seventy-six(38%)UU positive cases were detected in the control group,while 155(77.5%)were detected in the observation group(χ^(2)=63.946,P<0.001). Serotype analysis showed that the number of patients with UU serotype 1,serotype 2,serotype 6,serotype 9 and mixed serotype in the observation group was significantly higher than that in the control group,and there was no significant difference in the number of patients without serotype classification. Comparison of Th17 cells and secreted related cytokines showed that the concentrations of IL-4,IL-17 and TGF-β in UU-positive patients were significantly higher than in UU-negative patients(P<0.001),while no significant difference was found in IL-10 and IL-6. Vaginal microecological analysis showed that the proportion of UU positive patients with normal bacterial diversity, bacterial density and vaginal pH was significantly lower than that of negative patients, while microecological dysregulation analysis showed that the proportion of UU positive patients was significantly higher than that of negative patients(P<0.05). Conclusion UU infection in women of childbearing age will change the vaginal microecology,and their cervical Th17 cells and inflammatory factors will increase significantly,suggesting inflammatory reaction which can cause the occurrence of cervical disease.