【摘要】：目的了解外陰陰道假絲酵母菌病的致病菌譜，并通過(guò)檢測(cè)復(fù)發(fā)性外陰陰道假絲酵母菌�。≧VVC）患者、單純外陰陰道假絲酵母菌病（VVC）患者和健康帶菌者陰道灌洗液中HBD-2、LL-37的蛋白濃度以及陰道局部脫落細(xì)胞中HBD-2、LL-37mRNA的表達(dá)水平，分析HBD-2、LL-37與VVC臨床癥狀嚴(yán)重程度的關(guān)系，探討HBD-2、LL-37與RVVC發(fā)病的關(guān)系及陰道局部固有免疫在RVVC的發(fā)病中的作用。 方法收集RVVC患者28例，VVC患者30例以及健康帶菌者30例作為研究對(duì)象。所有研究對(duì)象記錄其一般資料，分泌物行真菌培養(yǎng)鑒定，并根據(jù)VVC評(píng)分標(biāo)準(zhǔn)評(píng)分。留取所有研究對(duì)象的陰道灌洗液標(biāo)本，用ELISA法測(cè)定灌洗液上清中HBD-2、LL-37的蛋白濃度，用熒光定量PCR法測(cè)定陰道局部脫落細(xì)胞中HBD-2、LL-37的mRNA表達(dá)水平。應(yīng)用SPSS17.0軟件，采用單因素方差分析、χ2檢驗(yàn)，檢驗(yàn)水準(zhǔn)為α=0.05。 結(jié)果1真菌培養(yǎng)結(jié)果顯示VVC組中非白假絲酵母菌占3.34%，，RVVC組中非白假絲酵母菌占14.28%，兩組差異無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）。2HBD-2的蛋白濃度及mRNA水平：對(duì)照組、VVC組及RVVC組的HBD-2蛋白濃度分別為：（64.31±13.45）μg/L、（72.27±11.92）μg/L、（56.97±10.36）μg/L。對(duì)照組、VVC組及RVVC組的HBD-2mRNA表達(dá)水平分別為：1.03±0.06、1.28±0.13、0.81±0.28。VVC組HBD-2的蛋白濃度及mRNA水平顯著高于對(duì)照組及RVVC組（P＜0.05），RVVC組HBD-2的蛋白濃度及mRNA水平較對(duì)照組及VVC組低（P＜0.05）。3LL-37的蛋白濃度及mRNA水平：對(duì)照組、VVC組及RVVC組的LL-37蛋白濃度分別為：（8.92±0.68）μg/L、（12.41±1.67）μg/L、（5.99±0.55）μg/L。對(duì)照組、VVC組及RVVC組LL-37mRNA表達(dá)水平分別為：1.01±0.04、1.45±0.25、0.83±0.19。VVC組LL-37的蛋白濃度及mRNA水平顯著高于對(duì)照組及RVVC組（P＜0.05），RVVC組LL-37的蛋白濃度及mRNA水平較對(duì)照組及VVC組低（P＜0.05）。4重度VVC組HBD-2、LL-37蛋白濃度比輕、中度VVC組和對(duì)照組低（P＜0.05），差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論1VVC及RVVC的致病菌中非白假絲酵母菌比例有上升趨勢(shì)，但主要致病菌種仍然是白假絲酵母菌。2正常陰道局部存在HBD-2及LL-37的少量表達(dá)，提示HBD-2、LL-37在陰道局部固有免疫防御中有一定作用。3VVC患者發(fā)病過(guò)程中陰道局部通過(guò)增加HBD-2、LL-37的分泌以抵抗假絲酵母菌的侵襲。RVVC患者陰道局部HBD-2、LL-37的低水平表達(dá)可能和其反復(fù)發(fā)作有關(guān)。4陰道局部HBD-2、LL-37的表達(dá)水平降低可能和和假絲酵母菌病的癥狀加重有關(guān)。
[Abstract]:Objective to investigate the pathogenic bacteria spectrum of vulvovaginal candidiasis and to detect the (RVVC) patients with recurrent vulvovaginal candidiasis. The protein concentration of HBD-2,LL-37 in vaginal lavage fluid and the expression level of HBD-2,LL-37mRNA in vaginal exfoliated cells in (VVC) patients with vulvovaginal candidiasis and healthy carriers were analyzed. The relationship between HBD-2,LL-37 and the severity of clinical symptoms of VVC was analyzed. To investigate the relationship between HBD-2,LL-37 and RVVC and the role of local immunity of vagina in the pathogenesis of RVVC. Methods 28 patients with RVVC and 30 healthy carriers were studied. All subjects recorded their general data, the secretion was identified by fungal culture, and scored according to the VVC score. The samples of vaginal lavage fluid were collected from all the subjects. The protein concentration of HBD-2,LL-37 in the supernatant of the lavage fluid was determined by ELISA method, and the mRNA expression of HBD-2,LL-37 in the local exfoliated cells of vagina was determined by fluorescence quantitative PCR method. Using SPSS17.0 software, single factor analysis of variance, 蠂 2 test, the test level is 偽 0. 05. Results 1 the results of fungal culture showed that non-white candida cerevisiae accounted for 14.28 in VVC group. There was no significant difference between the two groups (P > 0.05) .2HBD-2 protein concentration and mRNA level were (64.31 鹵13.45) 渭 g / L, (72.27 鹵11.92) 渭 g / L, (56.97 鹵10.36) 渭 g / L in control group and RVVC group, respectively. The HBD-2mRNA expression levels in the control group and the RVVC group were 1.03 鹵0.06 鹵1.28 鹵0.13 鹵0.81 鹵0.28.VVC, respectively, which were significantly higher than those in the control group and the RVVC group (P < 0. 05). The HBD-2 protein concentration and mRNA level in the RVVC group were significantly lower than those in the control group and the VVC group (P < 0. 05). 3LL-37 protein concentration was significantly lower than that in the control group and the RVVC group (P < 0. 05). The concentration of LL-37 protein in control group and RVVC group were (8.92 鹵0.68) 渭 g / L, (12.41 鹵1.67) 渭 g / L, (5.99 鹵0.55) 渭 g / L, respectively. The LL-37mRNA expression levels in the control group and the RVVC group were 1.01 鹵0.04 and 1.45 鹵0.25 鹵0.83 鹵0.19.VVC, respectively, and the LL-37 protein and mRNA levels were significantly higher than those in the control group and the RVVC group (P < 0. 05). The LL-37 protein concentration and mRNA level in the RVVC group were significantly lower than those in the control group and the VVC group (P < 0. 05). The HBD-2,LL-37 protein levels in the severe VVC group were significantly lower than those in the control group and the VVC group (P < 0. 05). The moderate VVC group was lower than the control group (P < 0. 05). Conclusion the proportion of non-Candida albicans which are pathogenic to 1VVC and RVVC is increasing, but the main pathogen is the presence of a small amount of HBD-2 and LL-37 in normal vagina of Candida albicans. The results suggest that HBD-2,LL-37 may play a role in the local innate immune defense of vagina. 3 the vaginal area may resist the invasion of Candida cerevisiae by increasing the secretion of HBD-2,LL-37 during the onset of VVC. The low level expression of HBD-2,LL-37 in vagina of patients with VVC may be reversed. The decrease of HBD-2,LL-37 expression in the vagina may be related to the exacerbation of the symptoms of Candida cerevitis.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R711.31

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