霉菌性阴道炎患者体内真菌分布、T淋巴细胞及相关细胞因子水平变化特点及意义

摘要

目的 探讨霉菌性阴道炎患者体内真菌分布、T淋巴细胞及炎性细胞因子水平变化特点及意义.方法 选取2017年1月—12月在我院治疗的霉菌性阴道炎患者182例作为观察组,同时选取女性健康志愿者110例作为对照组,检测2组受试者阴道分泌物中T淋巴细胞及细胞因子水平,同时对观察组阴道分泌物进行真菌培养.结果 182例患者中,病原菌以白色念珠菌为主,占43.41%;观察组阴道分泌物CD3+、CD4+和CD8+T淋巴细胞水平分别为(52.12±10.45)%、(33.30±8.23)%和(25.10±9.22)%,明显低于对照组(P均＜0.05);观察组阴道分泌物IL-2、TNF-α和IFN-γ分别为(7.21±1.42)pg/ml、(17.90±4.55)pg/ml和(19.81±4.50)pg/ml,明显低于对照组(P均＜0.05),而IL-4和IL-10分别为(40.32±8.33)pg/ml和(25.66±4.33)pg/ml,明显高于对照组(P均＜0.05);复杂性霉菌性阴道炎患者阴道分泌物CD3+、CD4+、CD8+T淋巴细胞以及IL-2、TNF-α和INF-γ水平明显低于普通霉菌性阴道炎患者(P均＜0.05),而IL-4和IL-10明显高于普通霉菌性阴道炎患者(P均＜0.05).结论 霉菌性阴道炎病原体以白色念珠菌为主,Th1/Th2细胞介导的细胞免疫参与了疾病过程.%Objective To investigate the distribution and significance of bacterial flora, T lymphocyte and cytokines in the patients with mycotic vaginitis. Methods A total of 182 mycotic vaginitis patients were selected from January to December 2017 in our hospital as observation group, meanwhile 110 healthy volunteers were selected as control group. The levels of T lymphocytes and cytokines in vaginal secretions of all subjects were detected, and fungal culture of vaginal secretions in the observation group was performed. Results Among the involved 182 patients, the pathogenic bacteria were mainly Candida albicans, accounting for 43.41%; The levels of CD3+, CD4+and CD8+T lymphocytes in vaginal secretion of observation group were (52.12±10.45)%, (33.30±8.23)% and (25.10±9.22%), which were significantly lower than those in the control group (P＜0.05); The IL-2, TNF-α and INF-γ in vaginal secretion of observation group were (7.21±1.42) pg/ml, (17.90±4.55) pg/ml and (19.81±4.50) pg/ml, which were significantly lower than those in the control group (P ＜ 0.05), and IL-4 and L-10 levels were (40.32±8.33) pg/ml and (25.66±4.33) pg/ml, which were significantly higher than the control group (P ＜ 0.05); The levels of CD3+, CD4+, CD8+T lymphocytes, IL-2, TNF-α and INF-γ in vaginal secretion of the complicated mycotic vaginitis patients were significantly lower than those of the normal mycotic vaginitis patients (P ＜ 0.05), while IL-4 and IL-10 leves were significantly higher than those of the common mycotic vaginitis patients (P ＜ 0.05). Conclusions Candida albicans is the main pathogen of mycotic vaginitis, and cellular immunity mediated by Th1/Th2 cells is involved in the disease process.