摘要
目的 探究细菌性阴道炎患者阴道微生物群与临床症状的相关性。方法 纳入2023年3-10月在本院妇产科诊疗的80例细菌性阴道炎(bacterial vaginosis, BV)患者作为本次研究BV组对象,另将同期来本院体检的80例适龄妇检健康女性为对照组,2组受试者无菌棉拭子采集阴道后穹隆部位分泌物样本采集,比较2组研究对象阴道主要关键菌群α(alpha)、beta多样性分析;阴道分泌物细胞、病原体形态学检验;白带量、异味程度等临床症状评分;阴道微生态Nugent评分;并对阴道关键菌群与临床症状进行相关性分析。结果 2组的chao 1指数和observed指数差异无统计学意义(P>0.05),2组在菌群的多样性程度方面差异有统计学意义(Shannon指数:P=0.043;Simpson指数:P=0.006),使用主坐标分析(PCoA)评估微生物结构,结果表明两组之间存在显著的微生物组成差异(P=0.001),且BV组的微生物多样性相对降低。BV组中加德纳菌Gardnerella、普雷沃菌Prevotella和阿托波菌Atopobium的相对丰度显著高于对照组(P<0.05),而乳酸杆菌Lactobacillus的相对丰度则显著低于对照组(P<0.05)。此外,BV组患者的阴道pH值及线索细胞阳性率也显著高于对照组。在BV组中,乳酸杆菌的相对丰度与pH值、Nugent评分以及临床症状评分均显示出显著的负相关性(r=-0.590、-0.411和-0.319,均P<0.05)。这表明乳酸杆菌的数量增加与较低的pH值、更低的Nugent评分以及较轻的临床症状相关。加德纳菌、普雷沃菌和阿托波菌的相对丰度与pH值、Nugent评分和临床症状评分均显示出显著的正相关性。具体相关系数:加德纳菌(r=0.667、0.405、0.236,均P<0.05),普雷沃菌(r=0.306、0.272、0.634,均P<0.05),阿托波菌(r=0.597、0.352、0.359,均P<0.05)。结论 细菌性阴道炎患者阴道内主要微生物加德纳菌、普雷沃菌和阿托波菌丰度更高、分布数量较多,而乳酸杆菌的数量比例较少,阴道微生物群与BV患者的临床症状具有相关性。
Objective To explore the correlation between vaginal microbiota and clinical symptoms in patients with bacterial vaginitis. Methods 80 cases of bacterial vaginitis(bacterial vaginosis, BV) patients diagnosed and treated in the Department of Obstetrics and Gynecology of Deyang People's Hospital from March 2023 to October 2023 were included in the BV group of the study, and 80 cases of healthy women of the appropriate age for gynecological checkups in the same period of time as control group of the study were included in the control group of the study, and aseptic cotton swabs of the subjects in both groups were collected from the area of the posterior vault of vagina. The secretion samples were collected from the posterior vaginal vault area of the two groups, and the diversity analysis of the vaginal key flora alpha and beta of the two groups was compared;the morphological examination of the vaginal secretion cells and pathogens;the clinical symptom scores of leucorrhoea volume and odor;the Nugent score of the vaginal micro-ecology;and the correlation analysis of the vaginal key flora and the clinical symptom was carried out. Results The differences between the chao 1 index and observed index of the 2 groups were not statistically significant(P>0.05),and the differences between the 2 groups were statistically significant in terms of the degree of diversity of the flora(Shannon index: P=0.043;Simpson index: P=0.006),Microbial structure was assessed using principal coordinate analysis(PCoA),which showed significant differences in microbial composition between the two groups(P=0.001) and a relative decrease in microbial diversity in the BV group. Specifically, the relative abundance of Gardnerella,Prevotella,and Atopobium was significantly higher in the BV group than in the control group(P<0.05),whereas the relative abundance of Lactobacillus was significantly lower than in the control group(P<0.05). In addition, the vaginal pH and clue cell positivity of patients in the BV group were also significantly higher than those in the control group. In the BV group, the relative abundance of Lactobacillus showed a significant negative correlation with pH,Nugent score, and clinical symptom score, with specific correlation coefficients of r=-0.590,-0.411,and-0.319,respectively(all P<0.05). This suggests that increased numbers of Lactobacillus were associated with lower pH,lower Nugent scores, and milder clinical symptoms. On the other hand, the relative abundance of Gardnerella,Prevotella and Atopobium showed significant positive correlations with pH,Nugent score and clinical symptom score. The specific correlation coefficients were as follows: Gardnerella:r=0.667,0.405,0.236(all P<0.05);Prevotella:r=0.306,0.272,0.634(P<0.05);and Atopobium:r=0.597,0.352,0.359(P<0.05). Conclusion In patients with bacterial vaginitis, the main microorganisms in the vagina, Gardnerella,Prevotella and Atopobium,were more abundant and distributed in higher numbers, whereas Lactobacillus was found in a smaller percentage of the population. The vaginal microbiota is correlated with the clinical symptoms of BV patients.
作者
卢维
刘莉
杨洪容
黄娟
LU Wei;LIU Li;YANG Hongrong;HUANG Juan(Deyang People's Hospital,Deyang 618099,Sichuang,China)
出处
《中国病原生物学杂志》
CSCD
北大核心
2024年第8期907-912,共6页
Journal of Pathogen Biology
基金
四川省卫生健康委员会医学科技项目(No.21PJ169)。
关键词
细菌性阴道炎
微生物群
临床症状
相关性
乳酸杆菌
bacterial vaginitis
microbial community
clinical symptoms
correlation
lactobacillus
作者简介
通讯作者:卢维(1988-),女,四川绵竹人,本科,主治医师,主要从事妇产科、计划生育相关研究,E-mail:747358268@qq.com。
