宫颈病变患者高危HPV感染及阴道菌群失调状况分析  

Analysis of High Risk HPV Infection and Vaginal Dysbacteriosis in Patients with Cervical Lesions

作　　者：康俭[1] 顾玮玲[1] KANG Jian;GU Weiling(Department of Gynecology,Affiliated Ninth People′s Hospital of Medical College of Shanghai Jiaotong University,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院妇科,上海200011

出　　处：《医学综述》2020年第7期1419-1422,1428,共5页Medical Recapitulate

摘　　要：目的分析宫颈病变患者高危型人乳头瘤病毒(HPV)感染及阴道菌群失调情况。方法选取2017年4月至2019年6月于上海交通大学医学院附属第九人民医院妇科进行健康体检的有性交史的女性为研究对象。研究对象均行宫颈脱落细胞学检查,剔除宫颈腺细胞异常者,对2000例出现非典型鳞状上皮细胞及以上者实施阴道镜下活组织检查,将病理检查结果正常者纳入对照组(n=1703),低级别上皮内瘤变者纳入低级别上皮内瘤变组(n=233),高级别上皮内瘤变者纳入高级别上皮内瘤变组(n=64)。采集研究对象的阴道分泌物进行阴道微生态检查及pH值检测,比较不同组别阴道微生态菌群、pH值及年龄分布情况,分析影响宫颈病变发生的因素。结果高级别上皮内瘤变组HPV感染率以及pH≥4.5的比例均高于低级别上皮内瘤变组和对照组[96.88%(62/64)比74.68%(174/233),12.98%(221/1703),75.00%(48/64)比61.37%(143/233),21.37%(364/1703)],低级别上皮内瘤变组高于对照组(P<0.05);三组年龄≥45岁的比例以及细菌、滴虫、假丝酵母菌感染阳性率比较,差异无统计学意义(P>0.05);Logistic回归分析显示,pH≥4.5及高危HPV感染可能是影响宫颈病变发生的危险因素(P<0.05)。结论随着宫颈病变级别的增加,HPV感染阳性率及pH≥4.5的比例显著增加,pH≥4.5及高危HPV感染可能是宫颈病变发生的危险因素。Objective To analyze the high risk human papilloma virus(HPV)infection and vaginal dysbacteriosis status in patients with cervical lesions.Methods The women with sexual experience physical examination in the Department of Gynecology in Affiliated Ninth People′s Hospital of Medical College of Shanghai Jiaotong University from Apr.2017 to Jun.2019 were included in the study.All the selected cases underwent cervical exfoliative cytology examination,and those with abnormal cervical glandular cells were excluded.A total of 2000 cases of atypical squamous cell of undetermined significance and above received biopsy under colposcope.The cases with normal pathological examination results were included in a control group(n=1703),and the cases with low grade intraepithelial neoplasia confirmed by pathological examination were included in a low grade intraepithelial neoplasia group(n=233),and the cases with high-grade intraepithelial neoplasia were included in a high-grade intraepithelial neoplasia group(n=64).The vaginal secretions of the objects were collected,and the vaginal micro-ecological examination and pH value test were performed.The vaginal micro-ecological flora,pH value and age distribution were compared among different groups,and the influencing factors for cervical lesions were analyzed.Results The HPV infection rate and percentage of pH≥4.5 in the high-grade intraepithelial neoplasia group were higher than those in the low-grade intraepithelial neoplasia group,and the low-grade intraepithelial neoplasia group higher than the control group[96.88%(62/64)vs 74.68%(174/233),12.98%(221/1703),75.00%(48/64)vs 61.37%(143/233),21.37%(364/1703)](P<0.05).There was no statistical difference in the percentage of age≥45,infection rate of bacteria,trichomonad and candida mycoderma bacteria among the three groups(P>0.05).Logistic regression analysis showed that high-risk HPV infection and pH value≥4.5 were the possible risk factors influencing cervical lesions(P<0.05).Conclusion With the increase of the grade of cervi

关 键 词：宫颈病变 高危人乳头瘤病毒感染 阴道菌群失调 PH值 

分 类 号：R737.33[医药卫生—肿瘤]