支原体及衣原体感染对慢性盆腔炎病情及阴道菌群的影响

Influence of Mycoplasma and Chlamydia infections on severity of chronic pelvic inflammatory disease and vaginal flora

目的分析解脲支原体(UU)、沙眼衣原体(CT)感染对慢性盆腔炎(CPID)病情及阴道菌群的影响。方法选取2019年1月-2022年11月在贵州中医药大学第二附属医院妇科就诊的185例CPID患者为病例组,随机选取同期150名女性健康体检者为对照组,对两组研究对象的UU、CT感染情况及阴道炎症情况、阴道菌群情况进行分析。结果病例组UU、CT感染比例均高于对照组(P<0.05),两组研究对象各类阴道炎的患病率比较,无统计学差异。病例组阴道菌群密度、菌群多样性以Ⅰ级或Ⅳ级为主,乳杆菌分级以Ⅱb级为主,对照组阴道菌群密度、菌群多样性以Ⅱ级或Ⅲ级为主,乳杆菌分级以Ⅱa级为主;病例组阴道微生态异常的比较高于对照组,差异均有统计学意义(P<0.05);与未感染UU或CT的患者相比较,病例组中感染UU或CT患者的病情程度以重度为主,阴道菌群密度和阴道菌群多样性中Ⅰ级或Ⅳ级较多,阴道微生态异常比例较高,差异均有统计学意义(P<0.05)。结论CPID患者具有较高的UU、CT感染率和明显的阴道菌群异常,感染UU或CT患者的病情和阴道微生态异常更加严重,UU、CT等非细菌性病原微生物的感染可能在CPID发生和发展机制中发挥了重要的作用。

OBJECTIVE To observe the influence of Ureaplasma urealyticum(Uu)and Chlamydia trachomatis(Ct)infections on severity of chronic pelvic inflammatory disease(CPID)and vaginal flora.METHODS A total of 185 patients with CPID who were treated in gynecology department of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from Jan 2019 to Nov 2022 were assigned as the case group,meanwhile,15o healthy women who received physical examination were randomly chosen as the control group.The prevalence of Uu and Ct infections,status of vaginitis and vaginal flora were observed.RESULTS The proportions of the subjects who had Uu and Ct infections were significantly higher in the case group than in the control group(P<0.05).There was no significant difference in the prevalence rates of vaginal inflammations between the two groups.Grade Ⅰ or Grade Ⅳ was dominant among the vaginal flora density and diversity in the case group,and grade Ⅱb was dominant among the Lactobacillus.Grade Ⅱ or Grade Ⅲ was dominant among the vaginal flora density and diversity in the control group,and grade Ⅱa was dominant among the Lactobacillus.The proportion of the subjects who had abnormal vaginal microecosystem was higher in the case group than in the control group,and there was significant difference(P<0.05).In the case group,the patients with Uu or Ct infection had more severe illness condition than the patients without Uu or Ct infection;grade Ior grade Ⅳ was dominant among the vaginal flora density and diversity,and the proportion of the Uu or Ct infection patients who had abnormal vaginal microecosystem was higher,and there were significant differences(P<0.05).CONCLUSION The CPID patients have high prevalence rates of Uu and Ct infections as well as the abnormal vaginal flora.The patients with Uu or Ct infection have more severe illness condition and abnormal vaginal microecosystem,and the non-bacterial pathogenic microorganisms such as Uu and Ct may play a significant role in pathogenesis and progression of CPID.