妊娠期外阴阴道假丝酵母菌病与阴道局部免疫环境变化_临床医学论文.docVIP

妊娠期外阴阴道假丝酵母菌病与阴道局部免疫环境变化_临床医学论文 妊娠期外阴阴道假丝酵母菌病与阴道局部免疫环境变化_临床医学论文 【摘要】 目的 了解妊娠期妇女阴道局部免疫特点，探讨妊娠期外阴阴道假丝酵母菌病的免疫学发病机理。 方法 选取 2005年 9月至 2006年8月在卫生部北京医院妇产科门诊就诊及进行健康体检的育龄妇女，分为妊娠外阴阴道假丝酵母菌病组(妊娠VVC，50例)、单纯外阴阴道假丝酵母菌病组(单纯VVC，55例)、正常对照组(35例)，经显微镜镜检初步筛选，留取阴道灌洗液，离心后分离上清液、淋巴细胞和上皮细胞成分。用ELISA法测定IgE浓度、流式细胞仪检测淋巴细胞表面免疫标志CD 4、CD 8。 结果 IgE水平妊娠VVC组为(1.903±0.274)g/L，单纯VVC组为(2.032±0.289)g/L，正常对照组为(1.347±0.287)g/L，妊娠VVC组与单纯VVC组和对照组比较，单纯VVC组与正常对照组，差异均有统计学意义(0.05);妊娠VVC组CD 4+细胞数、CD 4 /CD 8均低于正常对照组，CD 8+细胞数高于正常对照组，差异均有统计学意义(0.05)。 结论 阴道局部免疫环境变化参与妊娠期VVC发病。 【关键词】 外阴阴道假丝酵母菌病;妊娠;免疫 　　【Abstract】 Objective To examine the local immune condition of vagina, and to investigate the immunological pathogenesis of vulvovaginal candidiasis during pregnancy.MethodsWomen who visited Beijing Hospital for prenatal care or for health examination during September 2005 to August 2006 were chosen and divided into three groups: pregnant women with vulvovaginal candidiasis (pregnant VVC group, 50 cases), nonpregnant women with VVC (nonpregnant VVC group, 55 cases), healthy women (control group, 35 cases). After primary microscopical screening, vaginal lavage was centrifuged to separate supernatant, lymphocyte and epithelium. Concentration of IgE was measured by ELISA, and surface immunological markers of CD4 and CD8 were detected by flow cytometer.ResultsIgE concentration of the pregnant VVC group was lower than that of the nonpregnant VVC group, but higher than that of the control group (all Pslt;0.05). CD4+ cells and CD4 /CD8 ratio for the pregnant VVC group were lower than those of the control group (0.05). However, CD8+ cells for the pregnant VVC group was higher than that of the control group (0.05).ConclusionThe changes in immune environment of vagina may play a role in the pathogenesis of pregnant vulvovaginal candidiasis. 　　【Key words】 Vulvovaginal candidiasis, Pregnancy, Immunity. 　　外阴阴道假丝酵母菌病(vulvovaginal candidiasis, VVC)是一种常见的妇产科感染性疾病，可引起外阴瘙痒不适，严重时可影响工作和生活。妊娠期妇女假丝酵母菌感染率明显高于非孕妇女，妊娠合并假丝酵母菌感染可导致一系列妊娠合并症的发生。影响