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  本文選題：復發(fā)性外陰陰道假絲酵母菌病 + 干擾素-γ　； 參考：《河北聯(lián)合大學》2014年碩士論文

【摘要】：目的本研究通過調(diào)查外陰陰道假絲酵母菌�。╲ulvovaginal candidiasis, VVC）和復發(fā)性外陰陰道假絲酵母菌�。≧ecurrent vulvovaginal candidiasis, RVVC）患者的一般情況和生活衛(wèi)生習慣等因素，同時檢測VVC和RVVC患者陰道局部IFN-γ、IL-10的水平，，探討陰道局部免疫功能與VVC和RVVC的發(fā)病的關系及發(fā)病的危險因素，以期為RVVC的發(fā)生和防治提供新的思路和方法。 方法選取2012年6月至2012年12月在河北聯(lián)合大學附屬醫(yī)院婦產(chǎn)科門診就診及進行健康體檢的育齡婦女為研究對象，參照第7版《婦產(chǎn)科學》診斷標準，診斷出復發(fā)性外陰陰道假絲酵母菌�。≧VVC）患者40例，另將健康組（40例）、單純外陰陰道假絲酵母菌�。╒VC）組（40例）作為對照，剔除陰道灌洗液中的血液污染者，實際研究樣本為：健康對照組（28例）、單純VVC組（30例）、RVVC組（30例）。據(jù)研究課題設計合理的調(diào)查表，調(diào)查工作由本人直接負責，采用面對面問卷調(diào)查形式，調(diào)查內(nèi)容包括研究對象的一般情況、個人衛(wèi)生習慣情況、性生活情況和飲食喜好等。所有研究對象經(jīng)簽署知情同意書后，均以5ml生理鹽水沖洗陰道宮頸管部、陰道上段，于后穹窿回抽灌洗液約3ml，所有灌洗液均不含血液成分。將所得灌洗液以3000r/min離心5min，分離上清液和細胞成分，分別置于-20℃和-80℃的冰箱凍存。上清液采用酶聯(lián)免疫吸附試驗（ELISA）法測定IFN-γ和IL-10的濃度；細胞成分采用逆轉(zhuǎn)錄多聚酶鏈式反應（RT-PCR）法半定量測定細胞因子IFN-γ、IL-10mRNA的表達水平。整理所得數(shù)據(jù)，輸入Microsoft Excel2007建庫，采用SPSS17.0統(tǒng)計軟件包進行統(tǒng)計分析。問卷調(diào)查數(shù)據(jù)采用單因素Logistic回歸分析，再將與疾病發(fā)生相關的因素運用多因素Logistic回歸分析。計量資料用均數(shù)+標準差（x—±s）表示，組間差異的比較采用方差檢驗或秩和檢驗。 結(jié)果1單因素Logistic回歸分析顯示：棉質(zhì)內(nèi)褲（P=0.020，OR=0.278，95%CI為0.096~0.813）和陰道沖洗（P=0.002，OR=6.412，95%CI為2.356~16.915）對VVC的發(fā)生均有統(tǒng)計學意義。多分類多因素Logistic回歸分析顯示：棉質(zhì)內(nèi)褲（P=0.027，OR=0.284，95%CI為0.092~0.861）和陰道沖洗（P=0.001，OR=6.397，95%CI為2.329~17.021）與VVC的發(fā)生均有統(tǒng)計學意義。棉質(zhì)內(nèi)褲的OR值均小于1，對VVC的發(fā)生起保護性因素作用；陰道沖洗的OR值均大于1，為VVC發(fā)生的危險因素。2RVVC、單純性VVC、健康女性IFN-γ蛋白水平分別為：1.67+0.14、1.81+0.16、1.92+0.12×100pg/ml，RVVC組和VVC組的表達水平均明顯低于對照組（P0.05），且RVVC組和VVC組之間的表達水平也有顯著性差異（P0.05），IFN-γmRNA表達結(jié)果與蛋白水平結(jié)果一致；RVVC、單純性VVC、健康女性IL-10蛋白水平分別為：1.14+0.19、1.07+0.16、0.67+0.15×100pg/ml，患病兩組的IL-10表達水平均明顯高于健康組（P0.05），但RVVC組和VVC組之間的表達水平無顯著性差異（P0.05），mRNA的表達與蛋白水平一致。 結(jié)論1婦女穿棉質(zhì)內(nèi)褲可能會降低VVC發(fā)病的風險，而陰道沖洗可能會增加VVC發(fā)病的風險。2RVVC的發(fā)生可能與研究對象的一般情況、個人衛(wèi)生習慣情況、性生活情況和飲食喜好等因素無關。3RVVC患者陰道的IFN-γ的水平明顯降低，提示IFN-γ水平下降可能與VVC反復發(fā)生有關。4RVVC患者和VVC患者陰道的IL-10的水平均明顯升高，提示陰道局部IL-10通過在下調(diào)T細胞免疫反應在RVVC及VVC發(fā)病中起著一定的作用。
[Abstract]:Objective To investigate the relationship between vaginal local immune function ( VVC ) and RVVC ( RVVC ) and the risk factors of vaginal local immune function ( VVC ) and RVVC ( RVVC ) , and to provide a new idea and method for the development and prevention of RVVC .

Methods 40 patients with recurrent vulvovaginal Candida disease ( RVVC ) were selected from June 2012 to December 2012 , and 40 healthy controls ( 40 cases ) and VVC group ( 40 cases ) were selected as controls . The results were as follows : healthy control group ( 28 cases ) , simple VVC group ( 30 cases ) and RVVC group ( 30 cases ) .
The expression level of cytokines IFN - 緯 and IL - 10mRNA was semiquantitatively determined by reverse transcription polymerase chain reaction ( RT - PCR ) method . The data obtained were analyzed by SPSS 17.0 statistical software package .

Results One - factor logistic regression analysis showed that cotton underwear ( P = 0.020 , OR = 0.278 , 95 % CI 0.096 ~ 0.813 ) and vaginal irrigation ( P = 0.002 , OR = 6.412 , 95 % CI 2.356 ~ 16.915 ) were statistically significant for VVC .
The expression levels of IFN - 緯 protein in RVVC group and VVC group were significantly lower than those in control group ( P0.05 ) , and the expression level of IFN - 緯 mRNA was consistent with the result of protein level .
The levels of IL - 10 in RVVC and VVC were 1.14 + 0.19 , 1.07 + 0.16 , 0.67 + 0.15 脳 100pg / ml , respectively . The levels of IL - 10 in both groups were significantly higher than those in healthy group ( P0.05 ) , but there was no significant difference between RVVC group and VVC group ( P0.05 ) .

Conclusion 1 Women wear cotton underwear may reduce the risk of VVC morbidity , and vaginal irrigation may increase the risk of VVC . The level of IFN - 緯 in the vagina of 3RVVC patients is obviously lower than that of VVC . The levels of IL - 10 in vagina of patients with RVVC and VVC are obviously increased , suggesting that local IL - 10 plays a role in the pathogenesis of RVVC and VVC in patients with RVVC and VVC .

【學位授予單位】：河北聯(lián)合大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R711.31

【參考文獻】

相關期刊論文 前1條

1 陳輝,劉維達;新型抗真菌藥物卡泊芬凈及其在臨床的應用[J];國外醫(yī)學.皮膚性病學分冊;2005年01期

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