广西医学

目的分析不孕症女性患者的生殖道解脲支原体感染情况，并探讨其与性功能障碍、阴道微生态及卵巢颗粒细胞丝裂原活化蛋白激酶（MAPK）信号通路的关系。方法分别选取85例女性不孕症患者、80例人工流产术后的健康女性作为研究组、对照组，比较两组的生殖道解脲支原体感染情况。根据生殖道解脲支原体感染情况将不孕症患者分为感染组（n=54）和无感染组（n=31），比较两组患者性功能障碍发生率、女性性功能指数（FSFI）量表得分、阴道微生态情况及卵巢颗粒细胞中MAPK信号通路关键因子的mRNA表达水平。结果研究组解脲支原体感染率高于对照组（分别为63.53%、1.25%，P<0.05）。与无感染组相比，感染组的性功能障碍发生率更高，性欲、性唤起、阴道润滑度、性高潮、性交痛维度得分及FSFI量表总分更低，阴道菌群密度异常率、阴道pH值异常率、阴道微生态失调率更高，卵巢颗粒细胞中c⁃Jun氨基末端激酶、p38、细胞外调节蛋白激酶的mRNA表达水平上调（P<0.05）。结论不孕症患者生殖道解脲支原体感染现象严峻。生殖道解脲支原体感染会在一定程度上引起不孕症患者性功能障碍、加重阴道微生态失调，并导致卵巢颗粒细胞中MAPK信号通路过度激活。

Objective To analyze the status of Ureaplasma urealyticum infection in genital tract of female patients with infertility, and to explore its relation with sexual dysfunction, vaginal microecosystem and ovarian granular cells mitogen activated protein kinase (MAPK) signaling pathway. Methods A total of 85 female patients with infertility, and 80 healthy females after artificial abortion operation were selected as study group or control group, respectively. The status of Ureaplasma urealyticum infection was compared between the two groups. Patients with infertility were assigned to infection group (n=54) or non⁃infection group (n=31) according to the status of Ureaplasma urealyticum infection. The incidence rate of sexual dysfunction, Female Sexual Function Index (FSFI) scale score, vaginal microecosystem status, and mRNA expression of MAPK signaling pathway key factors in ovarian granular cells were compared between patients of the two groups. Results The infection rate of Ureaplasma urealyticum was higher in the study group than in the control group (63.53% and 1.25%, respectively, P<0.05). Compared with the non⁃infection group, the infection group yielded a higher incidence rate of sexual dysfunction, and lower scores of dimensions in terms of sexual desire, sexual arousal, vaginal lubrication, orgasm, and dyspareunia, and a lower total score of FSFI scale, as well as higher abnormal rate of vaginal flora density, abnormal rate of vaginal pH value, and vaginal microecological dysregulation rate, and elevated mRNA expressions of c⁃Jun N⁃terminal kinase, p38, extracellular regulated protein kinase in ovarian granular cells (P<0.05). Conclusion Ureaplasma urealyticum infection in the genital tract of infertility patients is still severe. Ureaplasma urealyticum infection in the genital tract can cause infertility patients with sexual dysfunction, increase vaginal microecological imbalance, and lead to MAPK signaling pathway over⁃activation in ovarian granular cells to a certain extent.

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