阴道菌群与子宫脱垂的相关性研究

研究阴道菌群与子宫脱垂的相关性，为该类患者的治疗提供参考。

选取杭州市妇产科医院门诊或体检中心募集的30例子宫脱垂患者（研究组）和30例健康人群（对照组）。利用细菌16S rDNA扩增技术分析两组对象阴道菌群的组成特点，并利用 LEfSe 及 LDA 分析具有显著差异的菌群。

在属水平上，绝经前人群阴道Oribacterium、Xanthomonadaceae_unclassified在研究组的相对丰度大于对照组（均P＜0.05）；绝经后人群阴道Finegoldia、Paracnuella、Clostridium_XVIII在研究组的相对丰度大于对照组，Alterileibacterium、Ileibacterium、Microbacteriaceae_unclassified在研究组的相对丰度小于对照组（均P＜0.05）。两组对象阴道菌群丰度指数（Sobs、Chao、Ace）及多样性指数（Shannon、Simpson、InvSimpson）差异无统计学意义（均P＞0.05）。研究组中绝经前人群阴道菌群Sobs、Chao、Shannon、Invsimpson指数小于绝经后人群，Simpson指数大于绝经后人群（均P＜0.05）。绝经后人群中，研究组对象Finegoldia丰度较高，对照组对象Sneathia丰度较高。绝经前人群中，研究组对象Fastidiosipila丰度较高，对照组对象Parvimonas丰度较高。ROC曲线提示，Anaerococcus和Sneathia的组合有助于预测子宫脱垂的发生。绝经后，研究组对象脂质代谢显著下降，而蛋白酶体代谢通路功能显著上升。

阴道菌群与子宫脱垂具有相关性。蛋白酶体代谢通路可能通过下调雌激素及受体水平参与了子宫脱垂的发生。

Relationship between uterine prolapse and vaginal microbiota

ObjectiveTo explore the correlationship between vaginal microbiota and uterine prolapse, providing a reference for the treatment. MethodsThirty healthy women (control group) and 30 women with uterine prolapse (observation group) from Hangzhou woman’s hospital were enrolled. Vaginal flora were detected by using pyrosequencing of barcoded 16S rRNA genes. The differential flora were analyzed with LEfSe and LDA. ResultsIn premenopausal women, the relative abundances of Oribacterium and Xanthomonadaceae_unclassified in the observation group were higher than those in the control group (all P＜0.05). In postmenopausal women, the relative abundances of Finegoldia, Paracnuella and Clostridium_XVIII in observation group were higher, while those of Alterileibacterium, Ileibacterium and Microbacteriaceae_unclassified were lower than those in the control group, respectively (all P＜0.05). The species richness indexes (Sobs, Chao, Ace) and the species diversity indexes (Shannon, Simpson and InvSimpson) had no statistical significance between the two groups. In the observation group, the Sobs, Chao, Shannon and Invsimpson indexes in premenopausal women were lower, while Simpson index was higher than those in postmenopausal women respectively (all P＜0.05). In postmenopausal women, Finegoldia was significantly higher in the observation group, while Sneathia was significantly higher in the control group. In premenopausal patients, Fastidiosipila was significantly higher in the observation group, and Parvimonas was significantly higher in the control group. ROC curve showed that the combination of Anaerococcus and Sneathia could help predict the occurrence of uterine prolapse. In postmenopausal women, the lipid metabolism decreased significantly, and the proteasome pathway function increased significantly in the observation group. ConclusionVaginal microecology is correlated with uterine prolapse. Proteasome and lipid metabolism may involve in the occurrence of uterine prolapse by down-regulating estrogen and receptor levels.