[1]吕晓丽,刘 羽,张 悦,等.妊娠早期阴道微生态状况分析[J].医学信息,2024,37(11):102-107.[doi:10.3969/j.issn.1006-1959.2024.11.019]
　LYU Xiao-li,LIU Yu,ZHANG Yue,et al.Analysis of Vaginal Microecological Status in Early Pregnancy[J].Journal of Medical Information,2024,37(11):102-107.[doi:10.3969/j.issn.1006-1959.2024.11.019]
点击复制

妊娠早期阴道微生态状况分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年11期
页码:
102-107
栏目:
论著
出版日期:
2024-06-01

文章信息/Info

Title:
Analysis of Vaginal Microecological Status in Early Pregnancy
文章编号:
1006-1959（2024）11-0102-06
作者:
吕晓丽; 刘 羽; 张 悦; 等
（1.安徽医科大学附属妇幼保健院妇二科，安徽 合肥 230000；2.安徽医科大学第五临床学院，安徽 合肥 230000）
Author(s):
LYU Xiao-li; LIU Yu; ZHANG Yue; et al.
(1.The Second Department of Gynecology,Maternal and Child Health Hospital,Anhui Medical University,Hefei 230000,Anhui,China;2.The Fifth Clinical College of Anhui Medical University,Hefei 230000,Anhui,China)
关键词:
阴道微生态; 妊娠期; 阴道菌群
Keywords:
Vaginal microenvironment; Pregnency; Vaginal flora
分类号:
R714.25
DOI:
10.3969/j.issn.1006-1959.2024.11.019
文献标志码:
A
摘要:
目的 分析妊娠早期女性阴道微生态的变化、阴道感染及其构成情况。方法 选取2021年9月-2022年5月在安徽医科大学附属妇幼保健院就诊的早期妊娠女性共436例作为妊娠组，另选取同期门诊就诊的正常非妊娠妇女118名作为非妊娠组，按年龄分为≥20岁组、21~30岁组、31~40岁组、41~50岁组。采用阴道微生态评价体系进行微生态评价，评价内容包括密集度、多样性、优势菌、菌群抑制或菌群过度增殖、病原微生物、Nugent评分、AV评分、阴道pH值。结果 妊娠组以革兰阳性大杆菌（即乳杆菌）为优势杆菌、AV评分在0~2分、pH值在3.8~4.5的女性占比高于非妊娠组，阴道微生态失衡、混合感染的比例均低于非妊娠组，BV、VVC的检出率高于非妊娠组，差异有统计学意义（P＜0.05）；妊娠组不同年龄段妊娠早期女性之间阴道革兰氏阳性杆菌占比比较，差异无统计学意义（P＞0.05）；妊娠组随着年龄增加，阴道菌群多样性、密集度、革兰氏阳性杆菌比例、Nugent 评分、AV评分及pH变化比较，差异无统计学意义（P＞0.05）；不同年龄段阴道感染及微生态失调情况比较，差异有统计学意义（P＜0.05）；妊娠组≤20岁组阴道微生态失调占比高于其他三组，差异有统计学意义（P＜0.05）；21~30岁、31~40岁和41~50岁组阴道感染及微生态失调情况两两比较，差异无统计学意义（P＞0.05）。结论 妊娠后机体内分泌及免疫系统会发生变化，使阴道微生态趋于稳定，不利于病原体和除乳杆菌之外的细菌定植；低龄妊娠会导致阴道微生态失衡率增高。
Abstract:
Objective To analyze the changes of vaginal microecology, vaginal infection and its composition in women during early pregnancy.Methods A total of 436 early pregnant women who were treated in the Maternal and Child Health Hospital, Anhui Medical University from September 2021 to May 2022 were selected as the pregnancy group, and 118 normal non-pregnant women who were treated in the outpatient clinic during the same period were selected as the non-pregnancy group. According to age, they were divided into ≥20 years old group, 21-30 years old group, 31-40 years old group and 41-50 years old group. The vaginal microecological evaluation system was used to evaluate the microecology. The evaluation contents included density, diversity, dominant bacteria, flora inhibition or excessive proliferation of flora, pathogenic microorganisms, Nugent score, AV score, vaginal pH value.Results The proportion of women with gram-positive bacillus (Lactobacillus) as the dominant bacillus, AV score of 0-2 scores and pH value of 3.8-4.5 in the pregnancy group was higher than that in the non-pregnancy group, the proportion of vaginal microecological imbalance and mixed infection was lower than that in the non-pregnancy group, and the detection rate of BV and VVC was higher than that in the non-pregnancy group, the differences were statistically significant (P<0.05). There was no significant difference in the proportion of vaginal gram-positive bacilli among women of different ages in the pregnancy group (P>0.05). With the increase of age, there was no significant difference in the diversity and density of vaginal flora, the proportion of gram-positive bacilli, Nugent score, AV score and pH change in the pregnancy group (P>0.05). There were statistically significant differences in vaginal infection and microecological imbalance among different age groups (P<0.05). The proportion of vaginal microecological imbalance in the pregnancy group ≤20 years old group was higher than that in the other three groups, and the difference was statistically significant (P<0.05). There was no significant difference in vaginal infection and microecological imbalance among the 21-30 years old, 31-40 years old and 41-50 years old groups (P>0.05).Conclusion After pregnancy, the body’s endocrine and immune systems will change, making the vaginal microecology stable, which is not conducive to the colonization of pathogens and bacteria other than Lactobacillus. Younger pregnancy can lead to an increased rate of vaginal microecological imbalance.

参考文献/References:

[1]Saraf VS,Sheikh SA,Ahmad A,et al.Vaginal microbiome: normalcy vs dysbiosis[J].Arch Microbiol,203(7):3793-3802.[2]陶址,廖秦平.阴道微生态的研究进展及临床意义[J].实用妇产科杂志,2018,34(10):721-723.[3]Romero R,Hassan SS,Gajer P,et al.The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women[J].Microbiome,2014,2(1):4.[4]DiGiulio DB,Callahan BJ,McMurdie PJ,et al.Temporal and spatial variation of the human microbiota during pregnancy[J].Proc Natl Acad Sci U S A,2015,112(35):11060-11065.[5]Bayar E,Bennett PR,Chan D,et al.The pregnancy microbiome and preterm birth[J].Semin Immunopathol,2020,42(4):487-499.[6]Oh KY,Lee S,Lee MS,et al.Composition of Vaginal Microbiota in Pregnant Women With Aerobic Vaginitis[J].Front Cell Infect Microbiol,2021,11:677648.[7]Chee WJY,Chew SY,Than LTL.Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health[J].Microb Cell Fact,2020,19(1):203.[8]Chen X,Lu Y,Chen T,et al.The Female Vaginal Microbiome in Health and Bacterial Vaginosis[J].Front Cell Infect Microbiol,2021,11:631972.[9]Masson L,Barnabas S,Deese J,et al.Inflammatory cytokine biomarkers of asymptomatic sexually transmitted infections and vaginal dysbiosis: a multicentre validation study[J].Sex Transm Infect,2019,95(1):5-12.[10]Kalia N,Singh J,Kaur M.Microbiota in vaginal health and pathogenesis of recurrent vulvovaginal infections: a critical review[J].Ann Clin Microbiol Antimicrob,2020,19(1):5.[11]陶址,廖秦平.妊娠期阴道微生态变化[J].中国实用妇科与产科杂志,2021,37(10):992-994.[12]Zhu B,Tao Z,Edupuganti L,et al.Roles of the Microbiota of the Female Reproductive Tract in Gynecological and Reproductive Health[J].Microbiol Mol Biol Rev,2022,86(4):e0018121.[13]Pruski P,Correia GDS,Lewis HV,et al.Direct on-swab metabolic profiling of vaginal microbiome host interactions during pregnancy and preterm birth[J].Nat Commun,2021,12(1):5967.[14]李丹,王世军.不同年龄段女性妊娠早期阴道微生态状况分析[J].中国医刊,2020,55(9):1005-1007.[15]Stout MJ,Zhou Y,Wylie KM,et al.Early pregnancy vaginal microbiome trends and pretermbirth[J].Am J Obstet Gynecol,2017,217(3):356.e1-356.e18.[16]Tabatabaei N,Eren AM,Barreiro LB,et al.Vaginal microbiome in early pregnancy and subsequent risk of spontaneous preterm birth: a case-control study[J].BJOG,2019,126(3):349-358.[17]林建丽,凌奕,陈华,等.B族链球菌感染对孕妇阴道微生态失衡和血清炎性因子与母婴结局的影响[J].中华医院感染学杂志,2022,32(3):462-465.[18]Schuster HJ,de Jonghe BA,Limpens J,et al.Asymptomatic vaginal Candida colonization and adverse pregnancy outcomes including preterm birth: a systematic review and meta-analysis[J].Am J Obstet Gynecol MFM,2020,2(3):100163.[19]Adachi KN,Nielsen-Saines K,Klausner JD.Chlamydia trachomatis Screening and Treatment in Pregnancy to Reduce Adverse Pregnancy and Neonatal Outcomes: A Review[J].Front Public Health,2021,9:531073.[20]Flaviani F,Hezelgrave NL,Kanno T,et al.Cervicovaginal microbiota and metabolome predict preterm birth risk in an ethnically diverse cohort[J].JCI Insight,2021,6(16):e149257.

相似文献/References:

[1]吴彦卿.妊娠期同型半胱氨酸和血脂水平对重度子痫前期的预测价值[J].医学信息,2018,31(16):157.[doi:10.3969/j.issn.1006-1959.2018.16.050]
　WU Yan-qing.Predictive Value of Homocysteine and Blood Lipid Levels during Pregnancy in Severe Preeclampsia[J].Journal of Medical Information,2018,31(11):157.[doi:10.3969/j.issn.1006-1959.2018.16.050]
[2]蒋达玲.左甲状腺素钠片治疗妊娠期甲状腺功能减退症的临床疗效观察[J].医学信息,2018,31(20):139.[doi:10.3969/j.issn.1006-1959.2018.20.042]
　JIANG Da-ling.Clinical Observation of Levothyroxine Sodium Tablets in the Treatment of Hypothyroidism during Pregnancy[J].Journal of Medical Information,2018,31(11):139.[doi:10.3969/j.issn.1006-1959.2018.20.042]
[3]杞朝梅,林 琳,张 晗,等.宫颈癌患者生殖道感染的研究进展[J].医学信息,2019,32(17):42.[doi:10.3969/j.issn.1006-1959.2019.17.014]
　QI Chao-mei,LIN Lin,ZHANG Han,et al.Progress in Research on Reproductive Tract Infection in Patients with Cervical Cancer[J].Journal of Medical Information,2019,32(11):42.[doi:10.3969/j.issn.1006-1959.2019.17.014]
[4]郭海珊,唐 莉,隗伏冰.外阴阴道假丝酵母菌病与人体微生态关系的研究[J].医学信息,2020,33(04):36.[doi:10.3969/j.issn.1006-1959.2020.04.012]
　GUO Hai-shan,TANG Li,KUI Fu-bing.Study on the Relationship between Vulvovaginal Candida and Human Microecology[J].Journal of Medical Information,2020,33(11):36.[doi:10.3969/j.issn.1006-1959.2020.04.012]
[5]周少曼.妊娠期糖尿病孕妇血糖指标异常与妊娠结局的关系[J].医学信息,2020,33(07):111.[doi:10.3969/j.issn.1006-1959.2020.07.033]
　ZHOU Shao-man.Relationship Between Abnormal Blood Glucose Index of Pregnant Women with Gestational Diabetes and Pregnancy Outcome[J].Journal of Medical Information,2020,33(11):111.[doi:10.3969/j.issn.1006-1959.2020.07.033]
[6]孙秀梅,张 蝶.糖化血红蛋白联合空腹血糖检测在妊娠期糖尿病筛查中的应用[J].医学信息,2020,33(11):171.[doi:10.3969/j.issn.1006-1959.2020.11.056]
　SUN Xiu-mei,ZHANG Die.Application of Glycated Hemoglobin Combined with Fasting Blood Glucose Detection in Gestational Diabetes Screening[J].Journal of Medical Information,2020,33(11):171.[doi:10.3969/j.issn.1006-1959.2020.11.056]
[7]王教香.妊娠期甲状腺功能减退对胎儿及妊娠结局的影响及防治[J].医学信息,2020,33(20):42.[doi:10.3969/j.issn.1006-1959.2020.20.012]
　WANG Jiao-xiang.The Influence of Hypothyroidism During Pregnancy on the Fetus and Pregnancy Outcome and Its Prevention[J].Journal of Medical Information,2020,33(11):42.[doi:10.3969/j.issn.1006-1959.2020.20.012]
[8]陈慧峰,潘琦文,李建湘.桂西北地区女性HR-HPV、HPVE6/E7mRNA感染调查及其与阴道微生态的关系[J].医学信息,2020,33(20):119.[doi:10.3969/j.issn.1006-1959.2020.20.036]
　CHEN Hui-feng,PAN Qi-wen,LI Jian-xiang.Investigation of Female HR-HPV and HPVE6/E7mRNA Infection in Northwestern Guangxi and Its Relationship with Vaginal Microecology[J].Journal of Medical Information,2020,33(11):119.[doi:10.3969/j.issn.1006-1959.2020.20.036]
[9]杨 森,赵春蓉,余文兴,等.妊娠期周围性面神经麻痹多种治疗方案效果比较[J].医学信息,2021,34(02):132.[doi:10.3969/j.issn.1006-1959.2021.02.036]
　YANG Sen,ZHAO Chun-rong,YU Wen-xing,et al.Comparison of the Effects of Various Treatments for Peripheral Facial Paralysis During Pregnancy[J].Journal of Medical Information,2021,34(11):132.[doi:10.3969/j.issn.1006-1959.2021.02.036]
[10]郭玉玲.妊娠期糖尿病的发病机制研究[J].医学信息,2021,34(18):53.[doi:10.3969/j.issn.1006-1959.2021.18.014]
　GUO Yu-ling.Study on the Pathogenesis of Gestational Diabetes[J].Journal of Medical Information,2021,34(11):53.[doi:10.3969/j.issn.1006-1959.2021.18.014]

更新日期/Last Update: 1900-01-01