阴道微生态与高危型HPV感染和宫颈病变的关系  

Relationships between vaginal microecosystem and high-risk HPV infection,cervical lesions

作　　者：张旭梅 李芹 柳露 邓琦 潘慧敏 ZHANG Xu-Mei;LI Qin;LIU Lu(Department of Gynecology, Kunming Yan＇an Hospital, Kunming , Yunnan 650051, China)

机构地区：[1]昆明市延安医院妇科,云南昆明650051

出　　处：《中国妇幼保健》2018年第8期1739-1741,共3页Maternal and Child Health Care of China

摘　　要：目的探讨阴道微生态对高危型人乳头瘤病毒感染和宫颈病变的诊断意义。方法选择2015年1月-2017年3月在该院妇科就诊的622例妇女为研究对象,进行阴道微生态、宫颈液基细胞学以及HR-HPV检测。结果所有研究对象中,乳酸杆菌检测大/中量380例,少或无242例;阴道清洁度1~2度522例,3~4度100例;BV、念珠菌感染、滴虫感染的阳性例数分别为76例、84例、2例;HPV 16阳性68例,HPV 18型阳性为0,HPV其他12型阳性138例,其中混合感染34例,HPV感染168例,无HPV感染者454例。经过随访后发现,宫颈正常者468例,存在宫颈病变者154例。对于阴道微生态与HPV、宫颈病变的关系进行分析,与HPV(-)比较,HPV(+)在乳酸杆菌、阴道清洁度以及念珠菌感染所占比例上,差异均有统计学意义(均P<0.05),与宫颈病变者比较,宫颈正常者在乳酸杆菌、阴道清洁度以及念珠菌感染所占比例上,差异均有统计学意义(均P<0.05)。结论对于阴道微生态而言,乳酸杆菌是维持正常的保护性因素,而阴道清洁度差及念珠菌感染则属于危险性因素,常容易诱发感染HPV及发生宫颈病变。Objective To explore the significance of vaginal microecosystem in diagnosis of high-risk human papillomavirus（ HPV）infection and cervical lesions. Methods A total of 622 women were selected from Department of Gynecology in Kunming Yan＇an Hospital from January 2015 to March 2017,then vaginal microecosystem,cervical liquid-based cytology test,and HR-HPV test were carried out.Results Among the women,great and middle amount of lactobacillus was found in 380 women,and few amount or no lactobacillus was found in 242 women; 522 women were found with vaginal cleaning degree 1-2,and 100 women were found with vaginal cleaning degree 3-4. The numbers of women with positive BV,candidiasis infection,and trichomonas infection were 76,84,and 2,respectively. The numbers of women with positive HPV 16,HPV 18,other 12 susbtypes of HPV were 68,0,and 138,respectively. The numbers of women with mixed infection,HPV infection,and non-HPV infection were 34,168,and 454,respectively. The results of follow-up showed that 468 women had normal cervix,and 154 women with cervical lesions. There were statistically significant differences in the proportions of lactobacillus infection,vagina cleaning degree,and candidiasis infection between the women with positive HPV and the women with negative HPV（ P 0. 05）. There were statistically significant differences in the proportions of lactobacillus infection,vagina cleaning degree,and candidiasis infection between the women with cervical lesions and the women with normal cervix（ P〈0. 05）. Conclusion Lactobacillus is a protective factor of vaginal microecosystem,while vagina cleaning degree and candidiasis infection are dangerous factors,which can induce HPV infection and cervical lesions.

关 键 词：阴道微生态 乳酸杆菌 阴道清洁度 高危型 HPV感染 诊断 

分 类 号：R737.33[医药卫生—肿瘤]