细菌性阴道疾病患者阴道菌群特征及与宫颈局部免疫功能相关性研究

Characteristics of vaginal flora in patients with bacterial vaginosis and its correlation with cervical local immune function

目的调查细菌阴道病患者阴道菌群分布情况和局部免疫功能变化情况,并分析两者间的相关性。方法纳入2019年5月~2020年5月在本院进行检查的确诊为细菌性阴道疾病患者68例为研究组,另选取同期进行体检后检查结果为正常的女性68例为对照组。对比两组阴道菌群特征变化,并检测两组患者宫颈分泌物CD^(+)4T、CD^(+)8T等免疫细胞水平,并对两者间的相关性进行分析。结果研究组沙眼衣原体检查阳性15.48%、人型支原体阳性41.07%显著高于对照组沙眼衣原体检查阳性1.47%、人型支原体阳性17.65,具有统计学意义(P<0.05);研究组乳酸菌具有较高的密集度,主要集中在0~Ⅰ级,占100%;阴道加特纳菌密集度增加,主要集中在Ⅱ~Ⅳ级,占78.57.对照组乳酸菌密集度,主要集中在Ⅱ~Ⅲ级级,占0.00%;阴道加特纳菌密集度集中在0~Ⅰ级占88.24%,两组对比均存在统计学意义(P<0.05)。观察组患者CD4^(+)T细胞水平(%)及CD4^(+)T/CD8^(+)T水平均低于对照组,差异有统计学意义(P<0.05)。细菌阴道炎患者阴道菌群特征与宫颈局部免疫细胞呈正相关(P<0.05)。结论细菌性阴道疾病患者阴道中乳酸杆菌降低,革兰氏阴性菌菌群显著增加,这导致阴道微生态平衡紊乱,局部宫颈免疫功能水平降低,两者呈正相关。临床应重视对两种指标的治疗和干预,促进疾病快速康复。

Objective To investigate the distribution of vaginal flora and the changes of local immune function in patients with bacterial vaginosis,and analyze the correlation between them.Methods 68 patients with bacterial vaginosis diagnosed in our hospital from May 2019 to may 2020 were selected as the study group,and 68 women with normal results after physical examination were selected as the control group.The changes of vaginal flora characteristics were compared between the two groups,and the levels of CD^(+)4T,CD^(+)8t and other immune cells in cervical secretions of the two groups were detected,and the correlation between the two groups was analyzed.result.Results The positive rates of Chlamydia trachomatis and Mycoplasma hominis in the study group were 15.48%and 41.07%respectively,which were significantly higher than those in the control group(1.47%and 17.65%respectively,P<0.05);the concentration of lactic acid bacteria in the study group was higher,mainly concentrated in 0I grade,accounting for 100%;the concentration of Gardnerella vaginalis increased,mainly in the IIIV level,accounting for 78.57%In the control group,the concentration of lactic acid bacteria was mainly concentrated in grade IIIII,accounting for 0.00%;the concentration of Gardnerella vaginalis was concentrated in grade 0I,accounting for 88.24%.There was statistical significance between the two groups(P<0.05).The levels of CD4^(+)T cells(%)and CD4^(+)T/CD8^(+)T in the observation group were lower than those in the control group(P<0.05).The characteristics of vaginal flora in patients with bacterial vaginitis were positively correlated with cervical local immune cells(P<0.05).Conclusion The decrease of lactobacilli and the increase of gram negative bacteria in vagina of patients with bacterial vaginal diseases lead to the disorder of vaginal microecology and the decrease of local cervical immune function.There is a positive correlation between the two.We should pay attention to the treatment and intervention of the two indicators in order to promote the rapid recovery of the disease.