■先前的研究表明,不孕患者子宫内膜炎和子宫内膜息肉的发病率较高,这两种疾病的发生与生殖道微生物群的变化有关。我们旨在确定患有慢性子宫内膜炎或子宫内膜息肉的不育患者生殖道(尤其是子宫内膜)中微生物群的组成和变化特征,并找出它与疾病发生的相关性。
■这是一项前瞻性研究。我们从胚胎移植前接受辅助生殖治疗的134例无症状不育患者中收集了生殖道活检样本。通过病理检查和16S核糖体RNA(16SrRNA)测序,我们确定了这些患者中慢性子宫内膜炎和子宫内膜息肉的分布,以及它们在生殖道微生物中的分布。
■与正常对照组相比,慢性子宫内膜炎和子宫内膜息肉患者生殖道微生物群发生改变,阴道存在显著的物种差异和相对丰度差异,子宫颈和子宫腔。乳酸菌,女性生殖道的主要菌群,显示子宫内膜疾病患者的丰度变化。由葡萄球菌组成的子宫内膜微生物群,加德纳菌,Atobobium,链球菌,肽链球菌,衣原体,梭杆菌,不动杆菌,等。与慢性子宫内膜炎和子宫内膜息肉有关。
■结果表明,与正常对照组相比,慢性子宫内膜炎或子宫内膜息肉不孕患者的子宫内膜菌群在物种相对丰度分布上确实有显著变化,表明局部微生态的变化可能是疾病发生的重要因素,甚至不良妊娠结局。子宫内膜微生态的进一步研究可能为进一步完善慢性子宫内膜炎的诊治策略提供新的契机。
The previous researches show that infertile patients have a higher incidence of endometritis and endometrial polyps, and the occurrence of these two diseases is related to changes in the microbiota of the genital tract. We aim to determine the composition and changing characteristics of the microbiota in the genital tract (especially the endometrium) of infertile patients with chronic endometritis or endometrial polyps, and find the correlation between it and the occurrence of diseases.
This is a prospective study. We collected genital tract biopsy samples from 134 asymptomatic infertile patients receiving assisted reproductive therapy before embryo transfer. Through pathological examination and 16S ribosomal RNA(16S rRNA) sequencing, we determined the distribution of chronic endometritis and endometrial polyps in these patients, as well as their distribution of reproductive tract microorganisms.
Compared with the normal control group, the microbial group of reproductive tract in patients with chronic endometritis and endometrial polyps is changed, and there are significant species differences and relative abundance differences in the vagina, cervix and uterine cavity. Lactobacillus, the dominant flora of female genital tract, showed a change in abundance in patients with endometrial diseases. Endometrial microbiota composed of Staphylococcus, Gardnerella, Atopobium, Streptococcus, Peptostreptococcus, Chlamydia, Fusobacterium, Acinetobacter, etc. are related to chronic endometritis and endometrial polyps.
The results showed that, compared with the normal control group, the endometrial microbiota of infertile patients with chronic endometritis or endometrial polyps did have significant changes in the relative abundance distribution of species, suggesting that changes in local microecology may be an important factor in the occurrence of disease, or even adverse pregnancy outcomes. The further study of endometrial microecology may provide a new opportunity to further improve the diagnosis and treatment strategy of chronic endometritis.