目的: 观察绝经后阴道炎阴道菌群、性激素水平变化的相关性。方法: 将绝经后细菌性阴道炎患者30例作为实验组,30例绝经后健康体检者作为对照组。比较两组人群阴道pH值、菌群密集度、多样性和性激素水平。结果: 绝经后细菌性阴道炎患者阴道pH值较对照组高(P＜0.05),革兰阳性杆菌组菌群密集度较对照组低(P＜0.05),菌群多样性高于对照组(P＜0.05);革兰阴性杆菌、阳性球菌的菌群密集度较对照组高(P＜0.05),黄体生成素(luteinizing hormone, LH)、卵泡刺激素(follicle-stimulating hormone, FSH)、催乳激素(prolactin, PRL)较对照组高,雌二醇(estradiol, E2)、孕酮(progesterone, PRGE)和睾酮(testosterone, TESTO)较对照组低,两组间各指标比较差异均有统计学意义(P＜0.05);绝经后E2、PRGE和TESTO越高,PRL越低,革兰阳性菌的菌群密集度越高。结论: 绝经后女性阴道微生态革兰阳性菌的菌群密集度与性激素存在相关性。
Objective: To observe the correlation between vaginal flora and sex hormone levels in postmenopausal vaginitis. Methods: Totally 30 patients with postmenopausal bacterial vaginitis were selected as the experimental group, and 30 postmenopausal healthy subjects were selected as the control group. The vaginal pH value, flora density, diversity and sex hormone levels were compared between the two groups. Results: The pH value of postmenopausal patients with bacterial vaginitis was higher than that of the control group(P＜0.05), the bacterial density of the Gram-positive bacteria group was lower than that of the control group(P＜0.05), and the bacterial diversity was higher than that of the control group(P＜0.05), the bacterial density of gram-negative bacilli and positive cocci was higher than that of the control group(P＜0.05), the levels of luteinizing hormone(LH), follicle-stimulating hormone(FSH) and prolactin(PRL) were higher than those of the control group, and estradiol(E2), progesterone(PRGE) and testosterone(TESTO) were lower than those of the control group, the differences between the two groups were statistically significant(P＜0.05), that was the higher the postmenopausal E2, PRGE and TESTO, the lower the PRL, and the higher the concentration of Gram-positive bacteria. Conclusion: The flora density of Gram-positive bacteria in the vaginal microecology of postmenopausal women is correlated with sex hormones.
[1] 孔北华, 马丁, 段涛, 等. 妇产科学[M]. 第10版. 北京: 人民卫生出版社, 2024: 233-237.
[2] 张薇. 阴道炎患者阴道微生态环境恢复治疗中乳杆菌活菌胶囊的临床作用观察[J]. 中国现代药物应用, 2020, 14(4): 156-157.
[3] 俞军英, 吴智聪. 乳酸菌阴道胶囊联合戊酸雌二醇治疗老年性阴道炎的效果观察[J]. 中国药物滥用防治杂志, 2023, 29(12): 2181-2188.
[4] Peebles K, Velloza J, Balkus JE, et al. High global burden and costs of bacterial vaginosis:a systematic review and meta-analysis[J]. Sex Transm Dis, 2019, 46(5): 304-311.
[5] Stewart LL, Vodstrcil LA, Coombe J, et al. Prevalence of bacterial vaginosis in postmenopausal women: a systematic review and meta-analysis[J]. Sex Health, 2022, 19(1): 17-26.
[6] Van Gerwen OT, Smith SE, Muzny CA, et al. Bacterial vaginosis in postmenopausal women[J]. Curr Infect Dis Rep, 2023, 25(1): 7-15.
[7] Dimitrakakis C, Bondy C. Androgens and the breast[J]. Breast Cancer Res, 2009, 11(5): 212.
[8] 陶跃平, 张能华. 细菌性阴道炎患者性激素水平与阴道清洁度的相关性分析[J]. 浙江临床医学, 2022, 24(5): 727.
[9] Ratten LK, Plummer EL, Bradshaw CS, et al. The effect of exogenous sex steroids on the vaginal microbiota: a systematic review[J]. Front Cell Infect Microbiol, 2021, 11(11): 1-19.
[10] Srinivasan S, Hua X, Wu MC, et al. Impact of topical interventions on the vaginal microbiota and metabolome in postmenopausal women: a secondary analysis of a randomized clinical trial[J]. JAMA Netw Open, 2022, 5(3): e225032.
[11] Brotman RM, Shardell MD, Gajer P, et al. Association between the vaginal microbiota, menopause status,and signs of vulvovaginal atrophy[J]. Menopause, 2014, 21(5): 450-458.
[12] Geng L, Huang W, Jiang S, et al. Effect of menopausal hormone therapy on the vaginal microbiota and genitourinary syndrome of menopause in chinese menopausal women[J]. Front Microbiol, 2020, 11(11): 1-11.
