Objective:To observe the preventive effect on premature rupture of membrane by treating Vulvovaginal Candidiasis(VVC) during pregnancy. Methods :30 cases of pregnancy with VVC with treatment,10 cases of pregnancy with VVC without treatment,30 cases of premature rupture of the membrane (PROM)without vaginitis,30 cases of normal term pregnancy were recuited. Women in the first two groups were followed up and their amniotic fluid and fetal membrane were cultivated and done Candida typing. The expression of MMP-9 and TIMP-1 in fetal membrane of four group patients were detected by immunohistochemistry.Results:①One pregnant woman with VVC without treatment had C. Krusei infection ,while no positive finding in pregnant women with WC with treatment. ②The expression of MMP-9 and MMP-9/TIMP-1 in fetal membrane had no statistical difference between PROM group and pregnancy with VVC without treatment ( P ＞0.05) ,but these expressions were still much higher than those in normal pregnancy group and pregnancy with VVC with treatment ( P ＜0.05);③The expression of TIMP-1 in fetal membranes of four groups had no statistical differences( P ＞ 0.05). Conclusions:When pregnancy with VVC occurs,the expression of MMP-9 in fetal membrane increases,and MMP-9/TIMP-1 imbalance will appear,thus the chance of premature rupture of membranes rises up. The treatment to Candida during pregnancy is useful in preventing PROM.%目的:观察妊娠合并外阴阴道假丝酵母菌病(VVC)的干预治疗对胎膜早破(PROM)的预防作用.方法:选取妊娠合并VVC治疗组30例,妊娠合并VVC未治疗组10例,足月非阴道炎胎膜早破组30例,足月正常妊娠组30例,观察前两组的妊娠结局并取羊水及胎膜做假丝酵母菌培养及分型鉴定;用免疫组织化学技术检测4组胎膜中基质金属蛋白酶-9(MMP-9)及金属蛋白酶组织抑制因子-1(TIMP-1)的表达率.结果:①未治疗组羊水和胎膜培养结果显示有1例克柔假丝酵母菌感染,治疗组羊水和胎膜培养结果均阴性;②胎膜早破组和未治疗组的MMP-9 PU值及MMP-9/TIMP-1 PU比值差异无统计学意义(P>0.05),但分别高于治疗组和正常对照组的MMP-9 PU值,MMP-9/TIMP-1 PU比值(P<0.05);③4组的TIMP-1的PU值比较差异无统计学意义(P>0.05).结论:妊娠合并VVC时,胎膜中MMP-9升高,MMP-9/TIMP-1失衡,增加了发生胎膜早破的危险性,治疗对预防妊娠合并VVC所致胎膜早破是有益的.
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