[1]谢薇薇,王昊珏,车艳美.真菌性阴道炎患者阴道分泌物炎性指标及微生态特征分析研究[J].现代检验医学杂志,2025,40(01):179-184,188.[doi:10.3969/j.issn.1671-7414.2025.01.034]
　XIE Weiwei,WANG Haojue,CHE Yanmei.Analysis of Inflammatory Indexes and Microecological Characteristics of Vaginal Secretions in Patients with Fungal Vaginitis[J].Journal of Modern Laboratory Medicine,2025,40(01):179-184,188.[doi:10.3969/j.issn.1671-7414.2025.01.034]
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真菌性阴道炎患者阴道分泌物炎性指标及微生态特征分析研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年01期
页码:
179-184,188
栏目:
论著
出版日期:
2025-01-15

文章信息/Info

Title:
Analysis of Inflammatory Indexes and Microecological Characteristics of Vaginal Secretions in Patients with Fungal Vaginitis
文章编号:
1671-7414（2025）01-179-07
作者:
谢薇薇，王昊珏，车艳美
（无锡市锡山人民医院妇产科，江苏无锡 214100）
Author(s):
XIE Weiwei, WANG Haojue, CHE Yanmei
(Department of Obstetrics and Gynecology，Wuxi Xishan People’s Hospital，Jiangsu Wuxi 214100, China)
关键词:
真菌性阴道炎; 阴道分泌物; 炎性指标; 微生物; 宫颈病变
分类号:
R711.31；R446.5
DOI:
10.3969/j.issn.1671-7414.2025.01.034
文献标志码:
A
摘要:
目的 探究真菌性阴道炎患者阴道分泌物炎性指标及微生态特征。方法 选取2019 年1 月～ 2022 年1 月无锡市锡山人民医院收治的真菌性阴道炎患者320 例，根据病理学检查，将患者分为A：单纯真菌性阴道炎组（n=216）和B：真菌性阴道炎伴有宫颈病变组（n=104）。比较两组患者的临床资料以及阴道微生物各项指标。采用随机森林算法分析患者宫颈病变的危险因素。结果 B 组阴道pH ＞ 4.5 人数、阴道分泌物清洁度Ⅲ ~ Ⅳ级人数以及TNF-α，IL-2，IL-12 水平高于A 组（t/χ2=4.862 ～ 12.924）；CRP，IL-4，IL-6，IL-10 显著低于A 组（t=9.025~12.962）， 差异具有统计学意义（均P<0.05）。A 组中卷曲乳杆菌占比最大，为18.89%，B 组中惰性乳杆菌占比最大为27.05%。B组阴道微生物菌群多样性显著高于A 组，A 组阴道菌群优势菌种为卷曲乳杆菌和瑞士乳杆菌，B 组优势菌种为金黄色葡萄球菌、短双歧杆菌、惰性乳杆菌和脆弱拟杆菌。与A 组相比，B 组患者糖基转移酶、脂肪酸生物合成和转运体等通路丰度显著降低，烟酰胺代谢、甘油磷脂代谢、异戊烯转移和氨基酸相关酶等通路丰度显著升高。随机森林分析显示，惰性乳杆菌、卷曲乳杆菌、金黄色葡萄球菌、加德纳菌、脆弱拟杆菌和短双歧杆菌是影响宫颈病变的重要菌群。结论 不同患者阴道分泌物中微生物构成比存在差异，真菌性阴道炎伴有宫颈病变患者阴道菌群多样性高于单纯真菌性阴道炎患者，惰性乳杆菌、卷曲乳杆菌、金黄色葡萄球菌、加德纳菌、脆弱拟杆菌和短双歧杆菌是影响宫颈病变的重要菌群。
Abstract:
Objective To explore the inflammatory indexes and microecological characteristics of vaginal secretions in patients with fungal vaginitis. Methods 320 patients with fungal vaginitis admitted to Wuxi Xishan People’s Hospital from January 2019 to January 2022 were selected. According to pathological examination, the patients were divided into A: [simple fungal vaginitis group (n=216)] and B: [fungal vaginitis with cervical lesions group (n=104)]. The clinical data and vaginal microbiological indexes of the two groups were compared. The risk factors of cervical lesions were analyzed using a random forest algorithm. Results The number of patients with vaginal pH ＞ 4.5, the numbet of patients with vaginal secretions in grade Ⅲ to Ⅳ and the levels of TNF-α, IL-2 and IL-12 in group B were higher than those in group A（t/χ2=4.862 ～ 12.924），CRP, IL-4, IL-6 and IL-10 were significantly lower than those in group A(t=9.025 ～ 12.962）, with statistical significance（all P<0.05), respecitively. Group A has the largest proportion of Lactobacillus crispatus (18.89%) and group B has the largest proportion of Lactobacillus iners (27.05%). The diversity of vaginal microflora in group B was significantly higher than that in group A. The dominant bacterial species in group A were Lactobacillus crispatus and Lactobacillus helyeticus, and the dominant bacterial species in group B were Staphylococcus aureus, Bifidobacterium breve, Lactobacillus iners and Bacteroides fragilis. Compared with group A, the abundances of Glycosyltransferases, Fatty acid biosynthesis and Transporters in group B were significantly reduced. Nicotinate and nicotinamide metabolism and Glycerophospholipid metabolism. The abundances of pathways such as metabolism, Prenyltransferases and Amino acid related enzymes were significantly increased. Random forest analysis showed that Lactobacillus iners, Lactobacillus crispatus, Staphylococcus aureus, Gardnerella vaginalis, Bacteroides fragilis and Bifidobacterium breve were important bacteria groups affecting cervical lesions. Conclusion The microbial composition ratio in vaginal secretions of different patients is different,and the diversity of vaginal flora in patients with fungal vaginitis accompanied by cervical lesions is higher than that in patients with simple fungal vaginitis, Lactobacillus iners, Lactobacillus crispatus, Lactobacillus crispatus, Lactobacillus iners, Lactobacillus crispatus, Staphylococcus aureus, Gardnerella vaginalis, Bacteroides fragilis and Bifidobacterium breve are important groups of bacteria affecting cervical lesions.

参考文献/References:

[1] 沈琰，曹姗．霉菌性阴道炎患者外周血、阴道分泌物炎症指标检测研究的临床意义[J]．中国妇幼保健，2020，35（1）：110-113． SHEN Yan, CAO Shan. Clinical significance of detection of inflammatory biomarkers in peripheral blood and vaginal secretion of patients with colpitis mycotica [J]. Maternal and Child Health Care of China, 2020, 35(1): 110-113.
[2] 马艳，谢灿，游璐．妊娠合并霉菌性阴道炎患者阴道微生态、血清炎性因子水平与妊娠结局的相关性分析[J]. 中国病原生物学杂志，2022,17(9):1099-1102. MA Yan, XIE Can, YOU Lu. Correlation analysis of vaginal microecology,serum inflammatory factor levels and pregnancy outcomes in patients with mycotic vaginitis during pregnancy [J]. Journal of Pathogen Biology, 2022, 17(9): 1099-1102.
[3] FALCARO M, CASTA?ON A, NDLELA B, et al. The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study[J]. Lancet, 2021, 398(10316): 2084-2092.
[4] 刘化勇，刘学军，高永丽，等. 阴道微生物菌群及宫颈局部免疫功能与宫颈上皮内瘤变的相关性分析[J]. 中国病原生物学杂志, 2021, 16(7): 805-808, 813. LIU Huayong, LIU Xuejun, GAO Yongli, et al. Analysis of the correlation between vaginal microbial flora and cervical immune function and cervical intraepithelial neoplasia[J]. Journal of Pathogen Biology, 2021, 16(7): 805-808, 813.
[5] KYRGIOU M, MOSCICKI A B. Vaginal microbiome and cervical cancer[J]. Seminars in Cancer Biology, 2022, 86(Pt 3): 189-198.
[6] WEI Zhentong, CHEN Hongliang, WANG Chunfeng, et al. Depiction of vaginal microbiota in women with high-risk human papillomavirus infection [J]. Frontiers in Public Health, 2020, 8: 587298.
[7] BRUSSELAERS N, SHRESTHA S, VAN DE WIJGERT J, et al. Vaginal dysbiosis and the risk of human papillomavirus and cervical cancer: systematic review and meta-analysis[J]. American Journal of Obstetrics and Gynecology, 2019, 221(1): 9-18.e8.
[8] 谢幸，孔北华，段涛．妇产科学[M].9 版. 北京: 人民卫生出版社,2001:241-243． XIE Xing，KONG Beihua，DUAN Tao．Obstetrics and Gynecology[M].9th Ed.Beijing:People’s Health Publishing House,2001:241-243．
[9] 中华人民共和国卫生部医政司 . 全国临床检验操作规程[S]. 3 版. 南京：东南大学出版社, 2006:733-744． Medical Administration Department of the Ministry of Health of the People’s Republic of China. National operating procedures for clinical examination[S]. 3th Ed. Nanjing：Southeast University Press, 2006:733-744．
[10] 张婧芳，周月娇，王凯丽．中药熏洗联合克霉唑乳膏治疗念珠菌性阴道炎疗效观察[J]．检验医学与临床，2021，18（5）：671-673． ZHANG Jingfang, ZHOU Yuejiao, WANG Kaili. Observation on the curative effect of fumigation with traditional Chinese medicine combined with clotrimazole cream in the treatment of candidal vaginitis[J]. Laboratory Medicine and Clinic, 2021, 18(5): 671-673.
[11] HAN Yue, REN Qingling. Does probiotics work for bacterial vaginosis and vulvovaginal candidiasis[J]. Current Opinion in Pharmacology, 2021, 61: 83-90.
[12] WANG Xinyan, ZHAO Ling, FAN Chong, et al. The role of IL-15 on vulvovaginal candidiasis in mice and related adverse pregnancy outcomes[J]. Microbial Pathogenesis, 2022, 166: 105555.
[13] MITRA A, MACINTYRE D A, NTRITSOS G, et al. The vaginal microbiota associates with the regression of untreated cervical intraepithelial neoplasia 2 lesions[J]. Nature Communications, 2020, 11(1): 1999.
[14] XU Xiaolin, ZHANG Yichan, YU Liqun, et al. A crosssectional analysis about bacterial vaginosis, highrisk human papillomavirus infection, and cervical intraepithelial neoplasia in Chinese women[J]. Scientific Reports, 2022, 12(1): 6609.
[15] NORENHAG J, DU J, OLOVSSON M, et al. The vaginal microbiota, human papillomavirus and cervical dysplasia: a systematic review and network meta-analysis[J]. BJOG : An International Journal of Obstetrics and Gynaecology, 2020, 127(2): 171-180.
[16] SO K A, YANG E J, KIM N R, et al. Changes of vaginal microbiota during cervical carcinogenesis in women with human papillomavirus infection[J]. PLoS One, 2020, 15(9): e0238705.
[17] DAS S, BHATTACHARJEE M J, MUKHERJEE A K, et al. Recent advances in understanding of multifaceted changes in the vaginal microenvironment: implications in vaginal health and therapeutics[J]. Critical Reviews in Microbiology, 2023, 49(2): 256-282.
[18] ROACHFORD O S E, ALLEYNE A T, NELSON K E. Insights into the vaginal microbiome in a diverse group of women of African, Asian and European ancestries [J]. Peer J, 2022, 10: e14449.
[19] ZHANG Yichan, XU Xiaolin, YU Liqun, et al. Vaginal microbiota changes caused by HPV infection in Chinese women[J]. Frontiers in Cellular and Infection Microbiology, 2022, 12: 814668.
[20] 李杨， 刘文杰， 郭莉． 外周血CD59，LGR5 和CK7 水平表达对宫颈癌前病变进展风险的预测价值研究[J]．现代检验医学杂志，2023，38（5）：105-109, 126． LI Yang, LIU Wenjie, GUO Li. Predictive value of combined detection of peripheral blood CD59， LGR5 and CK7 on the risk of progression of cervical precancerous lesions[J]. Journal of Modern Laboratory Medicine, 2023, 38(5): 105-109, 126.
[21] LYON L M, DORAN K S, HORSWILL A R. Staphylococcus aureus fibronectin-binding proteins contribute to colonization of the female reproductive tract[J]. Infection and Immunity, 2023, 91(1): e0046022.
[22] DONG Binhua, HUANG Yuxuan, CAI Hongning, et al. Prevotella as the hub of the cervicovaginal microbiota affects the occurrence of persistent human papillomavirus infection and cervical lesions in women of childbearing age via host NF-κB/C-myc[J]. Journal of Medical Virology, 2022, 94(11): 5519-5534.
[23] ANTON L, FERGUSON B, FRIEDMAN E S, et al. Gardnerella vaginalis alters cervicovaginal epithelial cell function through microbe-specific immune responses[J]. Microbiome, 2022, 10(1): 119.
[24] 王莹．阴道微生态与人乳头瘤病毒感染及宫颈病变的关系分析[J]．中国现代药物应用，2022，16（21）：23-26. WANG Ying. Correlation analysis between vaginal microecology and human papillomavirus infection and cervical lesions[J]. Chinese Journal of Modern Drug Application, 2022, 16(21): 23-26.
[25] 刘洋．TCT 检查中不同级别宫颈病变患者的阴道微生态特征研究[J]．医学理论与实践，2023，36（24）：4268-4270． LIU Yang. Vaginal microecological characteristics of patients with different levels of cervical lesions during TCT examination[J]. the Journal of Medical Theory and Practice, 2023, 36(24): 4268-4270.

备注/Memo

备注/Memo:
基金项目：无锡市卫生健康委科研项目（M202007）。
作者简介：谢薇薇（1986-），女，硕士研究生，主治医师，研究方向：妇产科。
通讯作者：王昊珏（1980-），男，硕士研究生，副主任医师，研究方向：妇产科，E-mail：xswanghao1980@163.com。
更新日期/Last Update: 2025-01-15