| 摘要: |
| ［摘要］ 目的 探讨阴道菌群失调与宫腔粘连（IUA）的关联性。方法 招募2022年1月1日至2022年5月31日于中南大学湘雅三医院接受治疗的IUA患者30例作为IUA组，另选择同期经宫腔镜检查确定无IUA的健康女性30名作为对照组。使用无菌拭子采集阴道中段分泌物样本，通过聚合酶链反应对16S rRNA基因的可变区进行扩增，并在MiSeq Illumina测序平台上进行高通量测序。通过生物信息学分析方法处理测序数据并进行菌群多样性分析等。结果 菌群多样性分析结果显示，IUA组的菌种多样性低于对照组，等级-丰度分布曲线提示对照组阴道中段菌群丰度更高，物种分布更均匀。Alpha多样性分析结果表明，IUA组的Chao指数、ACE指数、谱系多样性指数、香农指数和观测物种数均显著低于对照组（P<0.05），而辛普森指数显著高于对照组（P<0.05）。IUA组中厚壁菌门的相对丰度显著高于对照组（P<0.05），而放线菌、拟杆菌、变形杆菌、梭杆菌、扁形菌门、疣微生物、糖杆菌的相对丰度显著低于对照组（P<0.05）。IUA组中乳酸杆菌原噬菌体Lj928、肺炎克雷伯菌、罗斯菌的相对丰度显著高于对照组（P<0.05），而阴道阿托波菌、双歧杆菌、假单胞菌、普雷沃菌、维氏气单胞菌、厦门希瓦菌、产黑素拟杆菌、卟啉单胞菌、考拉杆菌属的相对丰度显著低于对照组（P<0.05）。结论 IUA患者阴道菌群丰富度及多样性显著下降，这可能是IUA发生的机制之一。改善阴道菌群失调可能有助于IUA的预防和治疗。 |
| 关键词: 宫腔粘连 阴道菌群 生物多样性 高通量核苷酸测序 |
| DOI：10.3969/j.issn.1674-3806.2025.05.11 |
| 分类号:R 711.74 |
| 基金项目:湖南省自然科学基金项目（编号：2024JJ9154） |
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| A study on correlation between vaginal dysbacteriosis and intrauterine adhesion |
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SHEN Rongjiong1,2, FAN Jieru1, HUANG Huan1, ZHAO Xingping1, SHU Changfa1, WANG Haiyan1
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1.Department of Gynaecology, the Third Xiangya Hospital of Central South University, Changsha 410013, China; 2.School of Clinical Medicine, Changsha Medical University, Changsha 410000, China
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| Abstract: |
| ［Abstract］ Objective To explore the correlation between vaginal dysbacteriosis and intrauterine adhesion(IUA). Methods Thirty patients with IUA who were treated in the Third Xiangya Hospital of Central South University from January 1, 2022 to May 31, 2022 were recruited as IUA group. Other 30 healthy women who underwent hysteroscopy at the same time to exclude IUA were selected as control group. A sample of secretions was collected at the midvagina using a sterile swab. The variable region of the 16S rRNA gene was amplified through polymerase chain reaction, and high-throughput sequencing was performed on the MiSeq Illumina sequencing platform. The sequencing data were processed through bioinformatics analysis method to analyze the bacterial diversity. Results The results of bacterial diversity analysis showed that the bacterial diversity in the IUA group was lower than that in the control group. The grade-abundance distribution curve suggested that the bacterial abundance in the midvagina was higher and the species were more evenly distributed in the control group. The Alpha diversity analysis results showed that the Chao index, ACE index, pedigree diversity index, Shannon′s index and the number of observed species in the IUA group were significantly lower than those in the control group(P<0.05), while the Simpson′s index in the IUA group was significantly higher than that in control group(P<0.05). The relative abundance of Firmicutes in the IUA group was significantly higher than that in the control group(P<0.05), while the relative abundances of Actinomyces, Bacteroides, Proteus, Fusobacteria, Planctomycetes, verrucous microorganisms and G.oxydans in the IUA group were significantly lower than those in the control group(P<0.05). The relative abundances of Lactobacillus prophages Lj928, Klebsiella pneumoniae and Roseburia inulinivorans in the IUA group were significantly higher than those in the control group(P<0.05), while the relative abundances of Atopobium vaginae, Bifidobacteria, Pseudomonas, Prevotella, Aeromonas veronii, Shewanella xiamenensis, Bacteroides melaninogenicus, Porphyromonas and Phascolarctobacteriumin the IUA group were significantly lower than those in the control group(P<0.05). Conclusion The richness and diversity of vaginal flora decrease significantly in IUA patients, which may be one of the mechanisms of IUA. Improving vaginal dysbacteriosis may contribute to the prevention and treatment of IUA. |
| Key words: Intrauterine adhesion(IUA) Vaginal flora Biodiversity High-throughput nucleotide sequencing |
