Explore Of The Related Factors In Famale With Lower Genital Tract Diseases And Experimental Study Of Defense Mechanism Of Nongonococcal Cervicitis In Women

Objective:1) To investigate the prevalence of female lower genital tract infections in Urumqi and analyze the relevant influencing factors. To provide epidemiological data for defense and treatment of female lower genital tract infections in Xinjiang.2)To investigate expression level and clinical significance of human beta-defensin-1、-2、-3mRNA in nongonococcal cervicitis.3) To investigate expression level and clinical significance of human beta-defensin-1,-2,-3mRNA in cervicitis with Chlamydia trachbomatis infection.4) To investigate the characteristic of mycoplasma infection and supply necessary laboratory methods for the clinical prevention and treatment. Methods:1) Total of1328women were selected and received gynecological examination and laboratory tests of the vaginal discharge between April2010and May2011in the First Affiliated Hospital of Xinjiang Medical University.815of them were randomly selected for questionnaire survey.2)72women with nongonococcal cervicitis and64control group were studied. The expression level of human beta-defensin-1、-2、-3mRNA(HBD-1、-2、-3) in cervical tissue was detected by reverse transcription-polymerase chain reaction(RT-PCR).3) The cervical tissues of32cases with Chlamydia trachbomatis infection were sampled and treated with Minocycline Hydrochloride Hydrate.After one month the pathogen was eliminated in20of32cases, which were included in case group (turn) and12in not turn,32cases were sampled with cervical tissues again.30healthy women were choosed as control group.The expression level of human beta-defensin-1,-2,-3mRNA in cervical tissue was detected by reverse transcription-polymerase chain reaction(RT-PCR).4) Gathered 815samples from Gynocology outpatients and used microscopic examination and cultivation to detect leucorrhea routine and ureaplasm urealyticum(UU) from the secretion of vigina and cervix. Set two groups according to the UU positive and negative infection.Results:1) The incidence of low reproductive tract infections in1328reproductive age women was57.62%, Positive rates were36.50%for bacterial vaginosis,27.75%for ureaplasma urealyticum,6.64%for chlamydia trachbomatis,4.83%for vulvovaginal candidiasis,3.62%for trichomoniasis,0.60%for gorlorrhoea, respcetively.32.20%of total cases suffered from mixed infections and67.69%one kind,25.91%two kinds and6.40%three kinds. The most of two kinds mixed infections were bacterial vaginosis and ureaplasma urealyticum (42.42%of two kinds mixed infections)and the next were ureaplasma urealyticum and chlamydia trachbomatis (24.24%).Bacterial vaginosis, ureaplasma urealyticum and chlamydia trachbomatis were the most in the three kinds mixed infections (50%of three kinds mixed infections)and the next were bacterial vaginosis, ureaplasma urealyticum and vulvovaginal candidiasis(20.83%). In multivariate logistic analysis, the factors associated with the female lower genital tract infections were: age, age of first sexual life, sexual life in menstruation, stop sexual life when feel unwell, cleaning vulva before sexual life with partner and history of gynecological infections.2)The expression of HBD-1, HBD-2, HBD-3(1.12±0.41,1.08±0.31,1.04±0.30) in cervical tissue of control group all could be found and compared with each other respectively no significance(all P>0.05).But the expression level of HBD-2, HBD-3(1.25±0.38,1.26±0.35) in cervical tissue of case group were more higher than normal group (t=2.651,-3.705, P=0.009,0.000). There was no difference (P>0.05) in expression level of HBD-1between case (1.22±0.45) and normal group (1.12±0.41). In the case group and control group, there were positive correlation between HBD-2and HBD-3(r=0.527,0.304, P=0.000,0.016), while HBD-1was no correlation (case group r=0.253,0.267, P=0.056,0.051; control group. r=-0.018,-0.093, P=0.892,0.473) compared with HBD-2and HBD-3.3)The expression level of HBD-2, HBD-3mRNA in case group were more higher than normal group (P=0.019,0.000). But there was no difference in expression level of HBD-1between the two groups (P>0.05).In the case group, the expression level of HBD-2, HBD-3mRNA of after treatment compared with before treatment were more lower (P=0.012,0.009), which the expression level of HBD-1was no difference (P>0.05), the same as all gene in case group not turn (P>0.05).4) Among815patients, the number of UU infection is257(38.7%)(1) among257UU positive patients, there was statistically significance in the cervicitis, vaginitis, cervisitis combined vaginitis, compared to the negative group (P<0.05).(2) the analysis to childbearing history of UU positive group,there was statistically significance in the pregnacy, abortion,natural labor (P<0.05).(3)among257UU positive patients, there was statistically significance in the vulo-cleaning, vaginal irrigation, number of sex partner, frequency of sex, console, sex during period.smoking, alcohol(P<0.05).(4) there was no statistically significance in the sex protection, cleaning, contraception (P>0.05). there was statistically significance in the bacterial, trichomonas and mixed vaginitis (P<0.05).Conclusions:1) For the prevalence rate of lower genital tract infections in Urumqi women is high. The first three places of lower genital tract infections were bacterial vaginosis, ureaplasma urealyticum and chlamydia trachbomatis. Mixed infections should arouse our attention. According to the influential factors, effective prevention and control measures should be conducted to reduce incidence of lower genital tract infections.2)The expression of human beta-defensin-2,-3mRNA are increase with infective cervices.They are strengthened through each other and play important roles in local cervical immunological defence, which provide new method of treatment.3) After drug intervention therapy,the expression level of human beta-defensin-2,-3are reduced.The expression level of defensin might be an effective judging index with cured or not for famele lower genital tract infectious diseases repeatedly and also provides a good experimental platform for clinical drug research, which provide new goal of treatment.4) There existed certain correlation between the UU positive patients and cervisitis, vaginitis, childbearing history, sexual behavior.