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目的:胎膜早破是一种常见但发生机制十分复杂的妊娠并发症。在所有的早产儿中,孕妇胎膜早破的比例高达33%。本研究针对胎膜早破产妇妊娠晚期阴道微生态及免疫因子的变化情况,分析阴道内菌群失调或局部免疫反应与胎膜早破的关系,为临床研究提供实验数据。方法:回顾性分析我院于2010年7月-2013年3月收治的34例胎膜早破孕妇的临床资料,同时选取于我院进行健康体检的妇女及产前检查的健康孕妇各34例作为对照。采集所有研究对象的阴道分泌物,对比分析各组样本中病原微生物的分布及免疫因子的浓度。结果:胎膜早破组乳酸杆菌的检出率要明显低于健康妇女组与健康孕妇组(79.4%vs 70.6%vs34.1,X2=8.438,P<0.05),三组研究对象其他菌属分布的差异比较无统计学意义(P>0.05);胎膜早破组阴道分泌物IL-6浓度与TNF-α浓度要显著高于健康妇女组与健康孕妇组(P<0.05)。结论:胎膜早破产妇阴道内的菌群分布与健康女性及孕妇有所不同,阴道内菌群失调及局部的免疫反应可能会导致胎膜早破的发生。
Objective: Premature rupture of membranes is a common but complicated mechanism of pregnancy complications. In all preterm children, the proportion of premature rupture of membranes in pregnant women is as high as 33%. In this study, the changes of vaginal microflora and immune factors in the third trimester of pregnant women with premature rupture of membranes were analyzed. The relationship between intravaginal flora or local immune response and premature rupture of membranes was analyzed to provide experimental data for clinical research. Methods: The clinical data of 34 pregnant women with premature rupture of membranes in our hospital from July 2010 to March 2013 were retrospectively analyzed. At the same time, 34 healthy pregnant women and healthy pregnant women as comparison. Vaginal secretions of all the subjects were collected, and the distribution of pathogenic microorganisms and the concentration of immune factors in each group were compared. Results: The detection rate of Lactobacillus in premature rupture of membranes was significantly lower than that in healthy women and healthy pregnant women (79.4% vs 70.6% vs 34.1, X2 = 8.438, P <0.05) (P> 0.05). The concentrations of IL-6 and TNF-α in vaginal secretion in premature rupture of membranes were significantly higher than those in healthy women and healthy pregnant women (P <0.05). Conclusion: The premature rupture of membranes in maternal vaginal flora distribution and healthy women and pregnant women are different, vaginal flora and local immune response may lead to premature rupture of membranes.