34例胎膜早破孕妇妊娠晚期阴道微生态及免疫因子变化状况分析

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，分析阴道内茵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％VS70．6％VS34．1，X2=8．438，P〈0．05），三组研究对象其他茵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．仪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，阴道内茵群失调及局部的免疫反应可能会导致胎膜旱破的发生。

Analysis of Vaginal Microecosystem and Immune Factor Change Condition on Premature Rupture of Membranes in Late Pregnancy with 34 Cases

Objective： The premature rupture of membrane is a common pregnancy complication with complex mechanism. There was more than 33% premature rupture of membranes coming up in all of the premature infants. This study aims at the changes of the micro ecology and immune factors in the vagina of maternal pregnancy with the late premature rupture of membranes in order to analyze the relationship between the vaginal dysbacteriosis or immune reactions and the premature rupture of membranes, as well as to provide the experimental data for clinical research. Methods： A retrospective analysis was conducted on the clinical data of 34 pregnant women with premature rupture of membranes, who were treated in our hospital from July 2010 to March 2013, were chosen to be the experimental group. And another 34 healthy women and 34 healthy pregnant women who were inspected by the regular examination were selected as the control group. The vaginal secretions were collected and the distribution of pathogenic microorganisms and concentration of immune factors were detected. Results： The lactic acid bacteria detection rate in premature rupture of membrane group was significantly lower than those for healthy women group and the healthy pregnant women group （79.4% vs 70.6% vs 34.1, XZ=-8.438, P〈0.05）, the difference in comparison of other bacteria genera distribution in the three groups were with no statistical significance（P〉0. 05）; The concentrations of IL6 and TNFa in premature rupture of membrane group was significantly higher than that in health women group and the healthy pregnant women group （P〈0.05）. Conclusion： Vaginal Flora Distribution from premature rupture of membrane parturient was different from those from the healthy and pregnant women, vaginal dysbacteriosis and local immune responses may lead to premature rupture of membranes.