女性终末期肾病月经异常患者性激素周期性改变与子宫内膜乳杆菌相关性分析
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摘要
目的研究女性终末期肾病月经异常患者性激素周期性改变与子宫内膜乳杆菌的相关性。方法选择2016年5月-2018年6月在本院诊治的126例ESRD女性患者为研究对象,其中月经失调患者66例。将ESRD患者中非月经异常患者设为月经正常组60例,月经周期延长患者为延长组36例,周期缩短患者为缩短组30例。收集患者临床资料,检测患者子宫内膜分泌物微生物组成。结果缩短组患者卵泡期、排卵期、黄体期E2水平明显低于正常组。延长组和缩短组卷曲乳杆菌(Lactobacillus crispatus)、惰性乳杆菌(Lactobacillus iners)、阴道乳杆菌(Lactobacillus vaginalis)检出率明显低于正常组,缩短组加氏乳杆菌(Lactobacillus gasseri)检出率明显低于正常组。卷曲乳杆菌(Lactobacillus crispatus)、惰性乳杆菌(Lactobacillus iners)、詹氏乳杆菌(Lactobacillus jensenii)、阴道乳杆菌(Lactobacillus vaginalis)与月经异常存在相关性。结论大部分ESRD女性患者存在月经失调和性激素水平异常,同时伴随子宫内膜微生物的改变。
Objective To explore the relationship between periodic changes in sex hormones and Lactobacilli in endometrium in women with end-stage renal disease(ESRD)and menstrual disorder.Methods 126 female ESRD patients treated in our hospital from May 2016 to June 2018 were enrolled,including 66 cases of menstrual disorder.The patients were divided into the normal cycle group(n=60),prolonged cycle group(n=36)and shortened cycle group(n=30)respectively.The patients′clinical data were collected,and the microbials in the patients′endometrial secretions were detected.Results The E2 levels in the follicular phase,ovulation phase and luteal phase of the shortened cycle group were significantly lower than those in the normal cycle group respectively.The detection rates of Lactobacillus crispatus,Lactobacillus iners and Lactobacillus vaginalis in the extended and shortened cycle groups were significantly lower than those in the normal cycle group,while the detection rate of Lactobacillus gasseri in the shortened cycle group was significantly lower than that in the normal cycle group.Conclusion Lactobacillus crispatus,Lactobacillus iners,Lactobacillus jensenii and Lactobacillus vaginalis are associated with menstrual abnormalities.Most female ESRD patients have menstrual disorder and abnormal sex hormone levels,accompanied by changes in the endometrial Lactobacillus community.
Objective To explore the relationship between periodic changes in sex hormones and Lactobacilli in endometrium in women with end-stage renal disease(ESRD)and menstrual disorder.Methods 126 female ESRD patients treated in our hospital from May 2016 to June 2018 were enrolled,including 66 cases of menstrual disorder.The patients were divided into the normal cycle group(n=60),prolonged cycle group(n=36)and shortened cycle group(n=30)respectively.The patients′clinical data were collected,and the microbials in the patients′endometrial secretions were detected.Results The E2 levels in the follicular phase,ovulation phase and luteal phase of the shortened cycle group were significantly lower than those in the normal cycle group respectively.The detection rates of Lactobacillus crispatus,Lactobacillus iners and Lactobacillus vaginalis in the extended and shortened cycle groups were significantly lower than those in the normal cycle group,while the detection rate of Lactobacillus gasseri in the shortened cycle group was significantly lower than that in the normal cycle group.Conclusion Lactobacillus crispatus,Lactobacillus iners,Lactobacillus jensenii and Lactobacillus vaginalis are associated with menstrual abnormalities.Most female ESRD patients have menstrual disorder and abnormal sex hormone levels,accompanied by changes in the endometrial Lactobacillus community.
引文
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[12] Kersh EN,Henning T,Vishwanathan SA,et al.SHIV susceptibility changes during the menstrual cycle of pigtail macaques[J].J Med Primatol,2014,43(5):310-316.
[2] Reckelhoff JF,Samson WK.Sex and gender differences in cardiovascular,renal and metabolic diseases[J].Am J Physiol Regul Integr Comp Physiol,2015,309(9):R1057-R1059.
[3] Birse K,Arnold KB,Novak RM,et al.Molecular signatures of immune activation and epithelial barrier remodeling are enhanced during the luteal phase of the menstrual cycle:implications for HIV susceptibility[J].J Virol,2015,89(17):8793-8805.
[4] Birse KD,Romas LM,Guthrie BL,et al.Genital injury signatures and microbiome alterations associated with depot medroxyprogesterone acetate usage and intravaginal drying practices[J].J Infect Dis,2016,215(4):590-598.
[5] Cuburu N,Graham BS,Buck CB,et al.Intravaginal immunization with HPV vectors induces tissue-resident CD8+T cell responses[J].J Clin Invest,2012,122(12):4606-4620.
[6] Bradley F,Birse K,Hasselrot K,et al.The vaginal microbiome amplifies sex hormone-associated cyclic changes in cervicovaginal inflammation and epithelial barrier disruption[J].Am J Reprod Immunol,2018,80(1):e12863.
[7] Sonnenberg GF,Artis D.Innate lymphoid cell interactions with the microbiota:implications for intestinal health and disease[J].Immunity,2012,37(4):601-610.
[8] Guthrie BL,Introini A,Roxby AC,et al.Depot medroxyprogesterone acetate use is associated with elevated innate immune effector molecules in cervicovaginal secretions of HIV-1-uninfected women[J].J Acquir Immune Defic Syndr,2015,69(1):1-10.
[9] Wira CR,Rodriguezgarcia M,Patel MV.The role of sex hormones in immune protection of the female reproductive tract[J].Nat Rev Immunol,2015,15(4):217-230.
[10] Eloe-Fadrosh EA,Mcarthur MA,Seekatz AM,et al.Impact of oral typhoid vaccination on the human gut microbiota and correlations with s.Typhi-specific immunological responses[J].PLoS One,2013,8(4):e62026.
[11] Brotman RM,Jacques R,Bavoil PM,et al.Microbiome,sex hormones,and immune responses in the reproductive tract:challenges for vaccine development against sexually transmitted infections[J].Vaccine,2014,32(14):1543-1552.
[12] Kersh EN,Henning T,Vishwanathan SA,et al.SHIV susceptibility changes during the menstrual cycle of pigtail macaques[J].J Med Primatol,2014,43(5):310-316.