摘要
目的 研究白细胞介素1受体a(IL-1Ra)基因多态性与无症状细菌性阴道病(aBV)患者不同转归的关系,以期对aBV患者进行分组管理。方法 对aBV患者进行自然转归的研究,在入组时,所有患者均留取了一份静脉血标本和阴道灌洗液的标本单独冻存。4个月后,临床研究结束时,根据临床结局,将完成研究的患者分为3组:自愈、进展和无改变。再检测所有患者IL-1Ra基因多态性以及阴道微环境中IL-1β和IL-1Ra浓度,并比对上述指标在3组不同结局的患者间的差别。结果 共有1 014例中国汉族女性患者入组,984例完成临床随访并获得临床结局数据。其中13例患者的冻存标本在检测时无法使用,共有971分标本完成检测。所有患者均检测到IL-1Ra基因,有A_(1)/A_(1)、A_(1)/A_(2)和A_(2)/A_(2) 3种基因型,主流人群的基因型为A_(1)/A_(1),最少见的基因型为A_(2)/A_(2),未发现少见类型的基因型女性。病情进展组的A_(2)等位基因的频率明显高于自愈组(P<0.05)。在所有患者的阴道灌洗液标本中均能检测到IL-1β和IL-1Ra存在。与进展组比较,自愈组的IL-1β水平明显偏低(P<0.05)。当携带A_(2)等位基因时,进展组IL-1β水平相对偏低,而IL-1Ra水平相对升高,无变化组的数值介于进展组和自愈组之间。结论 aBV患者中的IL-1Ra基因多态性特征与阴道分泌物中的IL-1Ra含量有关。携带等位基因A_(2)与IL-1Ra含量升高、IL-1β含量降低有密切相关性。携带等位基因A_(2)可能通过与IL-1Ra和IL-1β有关的机制影响了aBV的临床转归。
Objective To investigate the relationship between interleukin 1 receptor a(IL-1Ra) gene polymorphism and different outcomes in asymptomatic bacterial vaginosis(aBV) patients with the aim of grouping and managing aBV patients.Methods In study on the natural attribution of aBV patients,all patients were enrolled and a sample of venous blood and vaginal lavage fluid were separately frozen.After 4 months at the end of the clinical study,patients who completed the study were divided into three groups based on clinical outcomes:self-healing,progressive,and unchanged.The IL-1Ra gene polymorphism,the concentration of IL-1β and IL-1Ra were tested,and the differences in the above indicators among three groups of patients with different outcomes were compared.Results 1 014 Chinese Han female patients were enrolled,and 984 patients completed clinical follow-up and obtained clinical outcome data.13 specimens were unusable during testing,with a total of 971 specimens completed the test.IL-1Ra gene was detected in all patients,with three genotypes:A_1/A_1,A_1/A_(2),and A_(2)/A_(2).Most population had a genotype of A_1/A_1,with the rarest genotype being A_(2)/A_(2).No rare genotype of female was found.The frequency of A_(2) alleles in the progression group was significantly higher than that in the self-healing group(P<0.05).IL-1β and IL-1Ra were detected in all vaginal lavage fluid samples.Compared with the progression group,IL-1β in the self-healing group was significantly lower(P<0.05).When carrying the A_(2) allele,IL-1β in progression group was relatively low,while the level of IL-1Ra was relatively high.The values of the unchanged group were middle.Conclusion The polymorphism characteristics of the IL-1Ra gene in aBV patients are related to the IL-1Ra content in vaginal secretions.Carrying allele A_(2) is related to the elevation of IL-1Ra,the decrease of IL-1β in vaginal secretions.Carrying allele A_(2) may affect the clinical outcome of aBV by some potential mechanism.
作者
张瑞
高佳惠子
董翰宇
李昶
尹海旭
Zhang Rui;Gao Jiahuizi;Dong Hanyu;Li Chang;Yin Haixu(Dept of Obstetrics&Gynecology,Peking University First Hospital,Beijing 100034)
出处
《安徽医科大学学报》
CAS
北大核心
2024年第2期362-365,共4页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金(编号:81471420)
教育部博士点新教师基金项目(编号:20130001120051)。
