【作者】 明燕虹；

【导师】 袁瑞；

【作者基本信息】 重庆医科大学 ， 妇产科学， 2010， 硕士

【摘要】 外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)是一种由假丝酵母菌引起的常见的育龄期妇科疾病。流行病学研究估计大约有75%妇女患过1次此症,其中大多数为育龄期妇女,而且约有5%的成年妇女曾患复发性外阴阴道假丝酵母菌病(recurrent vulvovaginal candidosis,RVVC)。RVVC是指一年中复发4次或者4次以上,并反复出现感染。随着RVVC发病机制研究的进展,目前认为RVVC的复发可能与阴道局部免疫功能异常有关,并且阴道宿主防御机制中的天然免疫因子近来受到关注。肺表面活性物质相关蛋白A (Pulmonary surfactant-associated protein A,SP-A)是阴道局部细胞分泌的一种具有多种免疫调节功能的蛋白质,其在阴道局部分泌物中的表达对于RVVC的发生发展具有一定作用。目的:探讨肺表面活性物质相关蛋白A(SP-A)在复发性外阴阴道假丝酵母菌病(RVVC)患者阴道分泌物中的表达及意义。方法:收集RVVC患者阴道分泌物28例,外阴阴道假丝酵母菌患者(VVC)及健康体检者(对照组)阴道分泌物各30例,采用酶联免疫吸附测定方法(enzyme-linked immunosorbent assay,ELISA)测定各组中SP-A蛋白的含量,用逆转录聚合酶链式反应(reverse transcription–polymerase chain reaction,RT–PCR)方法检测各组中SP-A的基因表达情况。结果:用ELISA方法检测各组中SP-A蛋白的含量发现:VVC组的SP-A明显高于对照组(P<0.05), RVVC组的SP-A高于对照组及VVC组(P<0.05)。RT-PCR方法发现:VVC组的SP-A mRNA的表达水平高于对照组(P<0.05),RVVC组的SP-A mRNA的表达水平明显高于对照组及VVC组(P<0.05)。结论:SP-A可能是RVVC患者抗假丝酵母菌的重要物质,其性质或数量的改变可能在RVVC的发病机制中发挥重要作用。更多还原

【Abstract】 Vulvovaginal candidiasis(vvc) is a kind of vulvovaginal inflammation caused by candida infection,which is a a common disorder in women of childbearing age. The infection affects approximately 75% of women at least once during their lives, most frequently young women of childbearing age. 5–8% of adult women have recurrent vulvovaginal candidosis. Patients,suffering of at least four episodes of candida infection during 1 year,have a recurrent infection and are therefore recognized and classified as recurring vulvovaginal candidosis (RVVC) patients.With the developments of the researches in pathogenic mechanisms, now it is believed that the recurrence have obvious relevance to the deficiency of vaginal-associated immunity.Recent studies have focused on the importance of the innate immune factors in the vaginal host defense mechanism against mucosal candidal infections.Research shows pulmonary surfactant-associated protein A(SP-A) is a protein produced by squamous epithelium,namely the vaginal mucosa,which have important immunoregulation function.The expression of SP-A in the vaginal fluid might contribute to the recurrence of RVVC.Objective:It was to study the expression and signification of pulmonary surfactant-associated protein-A in the vaginal fluid of recurrent vulvovaginal candidiasis(RVVC).Methods:Human vaginal fluid from 28 RVVC patients,30 VVC patients and 30 healthy women(the control group)were collected, respectively.Enzyme-linked immunosorbent assay(ELISA) was applied to detect the levels of SP-A protein.The expression of SP-A gene was detected by reverse transcription–polymerase chain reaction (RT–PCR).Results:The levels and of SP-A of VVC group were higher than that of the control group ( P < 0. 05).The levels of SP-A of recurrent vulvovaginal candidiasis (RVVC) group were higher than those of VVC group and control group.The expression of SP-A mRNA in VVC was higher than that in the control group.The expression of SP-A mRNA in RVVC was significantly higher than those of VVC group and control group.Conclusion:SP-A might be an essential component in RVVC resistance. The qualitative and quantitative alterations of normal SP-A may play a role in the pathogenesis of RVVC.更多还原