阴道镜Reid评分对HIV感染妇女宫颈病变和HPV感染的诊断价值  

The Value of Colposcopic Reid Score in Diagnosis of Cervical Lesions and HPV Infection in Women with HIV Infection

作　　者：张红芸[1] 飞秋月 顾林莉[1] 朱珉[1] 钱虹[1] 王艳[1] 

机构地区：[1]昆明医科大学第一附属医院,云南昆明650032 [2]曲靖市妇幼医院,云南曲靖655000

出　　处：《昆明医科大学学报》2013年第8期141-143,149,共4页Journal of Kunming Medical University

基　　金：云南省2012艾滋病防治创新项目(2012010)

摘　　要：目的探讨电子阴道镜Reid评分对HIV感染妇女宫颈病变和HPV感染的诊断价值,为HIV感染妇女寻找一种廉价、方便、可行的筛查方法.方法对95例确诊为HIV感染的妇女进行宫颈液基细胞学检查、HPV检测、阴道镜检查及Reid评分,如有一项提示异常则行宫颈活检,以阴道镜联合病理诊断做为金标准进行病例对照研究.结果宫颈损害程度的增加,RCI的评分也随之增加,两者高度相关(r=0.753,P=0.00);Reid评分对于高级别CIN的诊断特异性高于高危HPV检测,敏感性高于液基细胞学检查;醋白对宫颈病变的诊断有相对较高的敏感性和特异性.结论阴道镜Reid评分对于宫颈病变尤其是高级别的宫颈癌前病变有很好的预测价值,阴道镜对HIV阳性妇女的宫颈癌筛查是一种高效、可行的检查方式,尤其是对于医疗资源相对缺乏的地区.Objective To explore the value of the electronic colposcopy Reid Score in diagnosis of cervical lesions and HP~ infection in women with HIV infection, so as to find out an inexpensive, convenient and feasible screening methods. Methods 95 cases of HIV-infected women were screened by cervical liquid based cytology, HPV testing, colposcopy and Reid Score. The patients with abnormal results in any one test mentioned above underwent cervical biopsy. The colposcopy was combined with pathological as a gold standard for case-control study. Results There was a statistically signi？cant correlation between colposcopic ndings and histopathological ndings and the score was increased as parallel as malignancy grade （r =0.753, P=0.00） . The specificity of Reid score for high grade CIN was better than high-risk HPV testing for CIN diagnosis and the sensitivity was better than liquid based cytology. Acetic acid staining has relatively high sensitivity and specificity in the diagnosis of cervical lesions. Conclusions Colposcope Reid score for cervical lesions has a predictive value, especially for high grade cervical precancerous lesions. Colposcopy for HIV-positive women cervical cancer screening is an efficient and feasible way, especially for the area where lack of medical resources.

关 键 词：人类免疫缺陷病毒 高危型人乳头瘤病毒 筛查 宫颈病变 阴道镜 

分 类 号：R713.4[医药卫生—妇产科学]