摘要
Abstract
Objective:To explore the expression and significance of interleukin(IL)-22 and IL-17A mRNA in vaginal secretions in patients with reproductive tract infections after intrauterine adhesions(IUA)separation.Methods:A retrospective study was conducted.A total of 108 patients with IUA who underwent adhesive separation surgery in the General Hospital of Jinshui District Zhengzhou City from January 2022 and January 2024 were selected and followed up for more than 6 months.The postoperative efficacy and reproductive tract infection of the patients were evaluated,and the pathogen identification was conducted for the infected patients.Vaginal secretions of patients were collected.The levels of IL-22 and IL-17A mRNA were detected by reverse transcription-polymerase chain reaction,and the detection results were analyzed.Results:After excluding 14 cases lost to follow up,94 patients were included.Among 94 patients with IUA,there were 23 cases of postoperative reproductive tract infection(infected group)and 71 cases without infection(non-infected group).A total of 34 pathogenic bacteria were detected in the infected patients,of which Gram-negative bacteria accounted for the highest proportion,67.65%(23/34),mainly Escherichia coli,Pseudomonas aeruginosa and Klebsiella pneumoniae,with 9,7 and 5 strains respectively.The improvement rate of American Fertility Society(AFS)score in the infected group was lower than that in the non-infected group[69.57%(16/23)vs.88.73%(63/71);χ2=4.759,P＜0.05],while the moderate to severe re-adhesion rate was higher than that in the non-infected group[39.13%(9/23)vs.16.90%(12/71);χ2=4.948,P＜0.05].The mRNA expression levels of IL-22 and IL-17A in vaginal secretions were higher than those in the non-infected group[IL-22 mRNA:1.67±0.32 vs.0.51±0.13;IL-17A mRNA:1.92±0.38 vs.0.34±0.09;t=25.019 and 32.646 respectively,P＜0.001].In the infected group,the mRNA expression levels of IL-22 and IL-17A in vaginal secretions of patients with no improvement in AFS were significantly higher than those with effective improvement in AFS[IL-22 mRNA:2.20±0.27 vs.1.44±0.31;IL-17A mRNA:2.24±0.33 vs.1.78±0.42;t=5.607 and 2.561 respectively,P＜0.05].Conclusions:After separation of intrauterine adhesion,reproductive tract infection in patients will affect the surgical effects and cause the increase in mRNA expression of IL-22 and IL-17A in vaginal secretions,thus detection of IL-22 and IL-17A mRNA expression levels can provide information for infection and efficacy judgment to a certain extent.关键词
宫腔粘连/宫腔粘连分离术/感染/白细胞介素-22/白细胞介素-17AKey words
Intrauterine adhesion/Intrauterine adhesion separation/Infection/Interleukin-22/Interleukin-17A分类
医药卫生
