外阴阴道假丝酵母菌病患者阴道人类防御素分泌及发病相关因素的研究

目的 通过对外阴阴道假丝酵母菌病(VVC)患者与健康妇女的比较,对VVC发病的相关因素进行分析,并研究VVC患者的阴道局部免疫状态.方法 应用病例对照研究方法,对VVC患者(VVC组,60例)及无VVC妇女(正常对照组,60例)进行比较,研究对象均填写调查表,取阴道分泌物进行阴道分泌物常规检查、pH值检测及细菌培养,用酶联免疫吸附试验对阴道冲洗液进行相关细胞因子[白细胞介素2、白细胞介素4、人类防御素5、人类β防御素(HBD)1、HBD2等]含量的检测分析.结果 (1)两组妇女的学历、对妇科感染的了解程度、妇科炎症病史、卫生习惯、性生活情况、药物应用情况比较,差异均无统计学意义(P>0.05);正常对照组慢性宫颈炎的发生率(43%,26/60)高于VVC组(22%,13/60),两组比较,差异有统计学意义(P<0.05).(2)正常对照组与VVC组妇女阴道pH值比较,差异无统计学意义(P>0.05).(3)VVC组妇女阴道分泌物检出假丝酵母菌43例,检出率为72%(43/60).(4)VVC组妇女阴道冲洗液中,人类防御素5、HBDI、HBD2含量[分别为(0.94±0.44)mg/L、(3.1±0.4)μg/L、(10±6)μg/L]明显高于正常对照组[分别为(0.61±0.27)mg/L、(2.7±0.4)μg/L、(7±3)μg/L],分别比较,差异均有统计学意义(P<0.05).结论 VVC是女性常见的外阴阴道炎症,在育龄期妇女VVC的发生与学历、对妇科感染的了解程度、妇科炎症病史、卫生习惯、性生活情况、药物应用情况无明显相关性.人类防御素的作用可能与VVC的发病密切相关.

Study on vaginal production of human defensins and the correlated pathogenetie factors of vulvovaginal candidiasis

Objective To investigate the correlated pathogenetic factors and vaginal local immunity in vulvovaginal candidiasis (VVC). Methods A case control study was conducted to compare VVC group (60 cases) with normal group (60 cases). All of the women filled up the specific questionnaires. Routine examination, pH test and bacterial culture were done on the vaginal discharge. Cytokines of the vaginal lavage were measured by enzyme linked immanosorbent assay. Results (1) Outcomes of the questionnaires: there was no significant difference between the two groups in educational background,knowledge of gynecologic infection, history of gynecologic infection, hygienic habit, sex life, or use of medicine (P >0. 05). The incidence of chronic cervicitis in normal group (43%, 26/60) was higher than in VVC group (22%, 13/60; P <0.05). (2) There was no difference in vaginal pH between the two groups ( P > 0. 05 ). (3) Detection rate of candida albicans by vaginal discharge routine examination was 72% (43/60). (4) The concentrations of interleukin (IL) 2, and IL-4 in vaginal lavage did not show significant difference between the two groups ( P > 0. 05 ), but the concentrations of human defensin 5,human beta-defensin (HBD) 1, and HBD2 in WC group [(0.94±0.44) mg/L, (3.1±0.4) μg/L,(10±6) μg/L] were higher than normal group (P < 0.05). Conclusions VVC is a common vulvovaginitis. There is no significant correlation between the incidence of VVC and educational background,knowledge of gynecologic infection, history of gynecologic infection, hygienic habit, sex life, or use of medicine in the child-bearing period. Human defensin may be closely correlated with the pathogenesis of VVC.