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目的探讨糖尿病(DM)患者阴道真菌菌群结构和生态分布特点。方法采用真菌18S rDNA克隆文库法,对不同血糖控制情况下DM患者的阴道真菌18S rDNA序列进行克隆和测序,构建阴道真菌18S rDNA克隆文库,建立系统发育树,获取DM患者阴道真菌菌群的结构和组成特征。结果 DM患者和健康妇女阴道标本中存在3个真菌类群14个属共20个种系型的真菌菌群。健康妇女(H组)、HbA1c<6.5%患者(DMa组)、HbA1c6.5%～7.5%患者(DMb组)和HbA1c>7.5%患者(DMc组)的阴道真菌菌落分别存在7、9、13和16个OTUs。念珠菌属为各组研究对象阴道真菌菌群的优势菌属,其阳性克隆子在H组、DMa组、DMb组和DMc组的比例呈上升趋势。DM患者阴道白色念珠菌、光滑念珠菌和克柔念珠菌的比例不同程度升高,而阴道酿酒酵母菌和Uncultured fungi的比例显著降低(P<0.05),伴随其他一些真菌菌种的出现和比例改变。结论 DM患者阴道真菌菌群分子生态结构发生不同程度改变,DM患者阴道真菌菌群紊乱程度与血糖控制情况关系密切。
Objective To investigate the flora structure and ecological distribution of vaginal fungi in patients with diabetes mellitus (DM). Methods Fungal 18S rDNA clone library was used to clone and sequence the 18S rDNA of vaginal fungus in DM patients with different glycemic control. The 18S rDNA clone library of vaginal fungus was constructed, and the phylogenetic tree was constructed to obtain the structure of vaginal fungal flora And compositional characteristics. Results In the vaginal specimens of DM patients and healthy women, there are 3 fungal groups and 14 genera and 20 genera of fungal flora. Vaginal fungal colonies of healthy women (H group), HbA1c <6.5% (DMa group), HbA1c 6.5% -7.5% (DMb group) and HbA1c> 7.5% And 16 OTUs. Candida is the predominant genus of vaginal fungi in each group, and the proportion of positive clones in group H, DMa, DMb and DMc is on the rise. The proportion of Candida albicans, Candida glabrata and Candida krusei in DM patients increased to some extent, but the proportion of Saccharomyces vaginalis and Uncultured fungi was significantly decreased (P <0.05), accompanied by the occurrence and proportion of other fungal species change. Conclusion The molecular structure of vaginal fungi in DM patients changes to varying degrees. The severity of vaginal fungal flora in DM patients is closely related to the control of blood glucose.