目的鉴定和分析解脲支原体(UU)各血清型在女性子宫颈的分布,并探讨其与宿主年龄、临床表型及阴道乳酸杆菌含量之间的关系。方法收集2012年10—12月就诊于浙江大学医学院附属邵逸夫医院的444名无泌尿生殖道疾病的体检女性(对照组)和342例泌尿生殖道疾病女性患者(疾病组)的子宫颈分泌物,进行UU培养和白带常规检测。根据多带抗原基因差异,对UU进行生物分群,并参照uu14种血清型的特异性核苷酸序列,用实时荧光定量PCR(RT—PCR)进行血清型分型。相关实验结果,基于Fisher精确检验及X^2检验进行统计学分析。结果对照组共分离出uu196株,疾病组共分离出uu214株。UU在疾病组的检出率(62.6%,214/342)显著高于对照组(44.1%,196/444)(P〈0.05)。对照组和疾病组均以1…369及混和血清型为主要血清型,而血清型的分布与宿主年龄无相关性(P〉0.05)。血清型3在疾病组所占比例(13.1%,28/214)显著高于对照组(5.1%,10/196),在阴道乳酸杆菌减少组所占比例(12.2%,27/221)显著高于乳酸杆菌对照组(5.8%,11/189)(均P〈0.05);而血清型6在疾病组中比例(14.0%,30/214)显著低于对照组(30.1%,59/196),在乳酸杆菌减少组(16.3%,36/221)中比例显著低于乳酸杆菌对照组(28.0%,53/189)(均P〈0.05)。结论血清型1…369及混合血清型为女性子宫颈感染UU的常见模式,感染UU血清型3或多种血清型混合感染可能与女性泌尿生殖道疾病相关。
Objective To explore the distribution of Ureaplasma urealyticum (UU) serotypes in cervix secretion and examine the relationship between serotype and host age, clinical phenotypes and vaginal Lactobacilli. Methods A total of 444 cervical secretion samples were collected from healthy subjects and 342 cervical secretion samples from females with genital diseases between October and December 2012 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. Biovar-typing was performed by PCR based on multiple-banded antigen (MBA) gene. And serotyping was performed by real-time PCR based on specific nucleotide sequences. Results The positive rate of UU in disease group (62. 6%, 214/342 ) was significantly higher than that in healthy group (44. 1%, 196/444, P 〈 0. 05 ). The main serotypes in both groups were 1,3,6,9 and mixed infection. No significant difference existed between host age and UU serotype ( P 〉 0. 05 ). The distribution of serotype 3 in disease and Lactobacilli abnormal group was significantly higher than that in healthy and Lactobacilli normal groups ( 13.1% (28/214) vs 5.1% ( 10/196), 12.2% (27/221) vs 5.8% ( 11/189 ), both P 〈 0. 05 ) whereas the distribution of serotype 6 in disease and Lactobacilli abnormal groups was significantly lower than that in healthy and Lactobacilli normal groups (14. 0% (30/214) vs 30. 1% (59/196), 16. 3% ( 36/221 ) vs 28. 0% (53/189), both P 〈 0. 05 ). Conclusions 1,3,6,9 and mixed infection are the main UU serotypes in female cervix. Serotype 3 and mixed infection may be associated with female genital infection.