阴道微生态异常与高危型人乳头瘤病毒感染及宫颈病变的关系  

Relationship among abnormal vaginal microecology,high-risk human papillomavirus infection and cervical lesions

作　　者：王爽[1] 袁学华[1] 柯盈月 李权伦 王字卉 郑柳莎 WANG Shuang;YUAN Xuehua;KE Yingyue;LI Quanlun;WANG Zihui;ZHENG Liusha(Department of Clinical Laboratory,Shiyan Maternal and Child Health Care Hospital,Shiyan,Hubei 442000,China)

机构地区：[1]十堰市妇幼保健院检验科,湖北十堰442000 [2]十堰市妇幼保健院体检中心,湖北十堰442000

出　　处：《中国微生态学杂志》2018年第8期959-963,共5页Chinese Journal of Microecology

摘　　要：目的探讨阴道微生态异常与高危型人乳头瘤病毒(HR-HPV)感染及宫颈病变的相关性。方法选取2015年1月至2017年6月在十堰市妇幼保健院妇科门诊接受宫颈病变筛查的562例患者为研究对象,分别进行阴道微生态、HR-HPV检测、宫颈脱落细胞检查和组织病理学活检,对检查结果进行分析。结果 562例患者中,宫颈病变发生率为16.01%,液基薄层细胞检测(TCT)阳性率为19.93%,HR-HPV感染率为28.47%,阴道微生态失调发生率为30.78%,其中细菌性阴道病(BV)、滴虫性阴道炎(TV)、外阴阴道假丝酵母菌病(VVC)、需氧菌性阴道炎(AV)和乳杆菌减少检出率分别为24.02%、3.20%、12.28%、8.54%和28.47%。宫颈病变患者微生态失调率为67.78%,明显高于正常组的23.73%(P<0.05)。宫颈病变患者其BV、VVC、AV和乳杆菌减少检出率分别为66.67%、30.0%、22.22%和75.56%,均明显高于正常者的15.89%、8.90%、5.93%和19.49%(P<0.05);宫颈病变患者HR-HPV阳性率为75.56%,明显高于正常者的19.49%(P<0.05)。HR-HPV阳性患者BV、VVC、AV和乳杆菌减少的检出率分别为51.88%、24.38%、16.88%和62.5%,明显高于HR-HPV阴性患者的12.94%、7.46%、5.22%和14.93%(P<0.05)。结论阴道微生态环境的改变与高危型HPV感染及宫颈病变的发生具有一定关系。Objective To explore the relationship among abnormal vaginal microecology,high-risk human papillomavirus（HR-HPV）infection and cervical lesions.Methods 562 patients who received cervical disease screening in our hospital were included and underwent vaginal microecological test,HR-HPV detection,cervical cytology test and histopathological biopsy.Analysis was performed on the inspection results.Results The incidence rate of cervical lesions was 16.01%.The positive rate of thin-layer cytological test（TCT）was 19.93%.The infection rate of HR-HPV was 28.47%.The incidence rate of vaginal dysbiosis was 30.78%.The detection rates of bacterial vaginosis（BV）,trichomonas vaginitis（TV）,vulvovaginal candidiasis（VVC）,aerobic vaginitis（AV）and Lactobacillus decrease were 24.02%,3.20%,12.28%,8.54% and 28.47% respectively.The rate of dysbiosis in the cervical lesions group was 67.78%,significantly higher than the 23.73%in the normal control group（P〈0.05）.The detection rates of BV,VVC,AV and Lactobacillus decrease in the cervical lesions group were 66.67%,30.0%,22.22% and 75.56%respectively,significantly higher than the 15.89%,8.90%,5.93% and 19.49% in the normal control group（P〈0.05）.The positive rate of HR-HPV in the cervical lesions group was 75.56%,significantly higher than the19.49%in the normal control group.The detection rates of BV,VVC,AV and Lactobacillus decrease among HRHPV positive patients were 51.88%,24.38%,16.88% and 62.5% respectively,significantly higher than the12.94%,7.46%,5.22% and 14.93% among HR-HPV negative patients（P〈0.05）.Conclusion Changes in vaginal microecological environment is closely related to high-risk HPV infection and cervical lesions.

关 键 词：阴道微生态 高危型人乳头瘤病毒 宫颈病变 相关性 

分 类 号：R446.5[医药卫生—诊断学]