深圳地区女性HIV合并宫颈HPV感染现状调查及临床干预的相关性研究  

Research of correlation between the current situation investigation and clinical intervention of female HIV complicated with cervical HPV infection in Shenzhen

作　　者：万建玉[1] 蔡秋娥[1] 王淼[1] 陈丽云[1] 汤雄文 WAN Jianyu;CAI Qiu′e;WANG Miao;CHEN Liyun;TANG Xiongwen(Department of Obstetrics and Gynecology,Shenzhen Third People′s Hospital,Shenzhen 518000,Guangdong,China)

机构地区：[1]广东省深圳市第三人民医院妇产科,广东深圳518000

出　　处：《中国性科学》2020年第3期27-31,共5页Chinese Journal of Human Sexuality

基　　金：深圳市卫生计生系统科研项目(SZFZ2017011)。

摘　　要：目的探究深圳地区女性HIV合并宫颈HPV感染的现状及临床干预效果。方法以2017年1月1日至2018年2月1日期间在广东省深圳市第三人民医院爱心门诊就诊、HIV阳性的女性作为研究对象。随机选取同期在广东省深圳市第三人民医院妇科门诊行宫颈癌筛查的HIV阴性女性作为对照,两组各选550例,对所有研究对象均行宫颈相关检测、免疫细胞和HIV病毒载量测定,统计HPV感染现状,对HPV感染率与CD4^+水平与HIV病毒RNA定量相关性进行分析。将HIV阳性合并感染HR-HPV的患者分为两组,一组采用抗HIV病毒治疗,另一组不进行任何治疗,对HIV阴性但HPV感染阳性的患者分为四组,A组采用重组人干扰素a2b乳膏+保妇康栓治疗,B组采用阴道干扰凝胶治疗,C组采用阴道保妇康栓治疗,D组不给于任何治疗,3疗程后,分别在停药后3个月、6个月、12个月对患者进行HPV定性及定量检查和LCT检测,评估疗效差别。结果 HIV阳性患者的HPV感染率、HR-HPV感染率、多重HPV感染、细胞学异常发生率和其他阴道疾病感染率显著高于HIV阴性患者,同时HIV阳性组的宫颈病变率和病变分期与HIV阴性患者组别之间存在显著的统计学差异(均P<0.05);HIV阳性合并HR-HPV感染组的CD4^+细胞数和CD4^+/CD8^+显著低于未合并HR-HPV感染组, HIV病毒载量显著高于未合并HR-HPV感染组,差异均具有统计学意义(均P<0.05);A组的好转率优于其他三组,B组和C组的好转率优于D组,均存在统计学差异(均P<0.05);在HIV阳性合并HR-HPV中采用抗病毒治疗组在术后的3个月、6个月、12个月的HR-HPV感染率、多重感染、自然转归细胞学异常均显著优于未抗HIV治疗组别,差异均具有统计学意义(均P<0.05)。结论 HIV病毒感染能够增加HR-HPV的感染机率,在此类患者的治疗上应该增加抗病毒治疗,同时在HPV感染的治疗上应该提倡联合用药的方式,对于疾病的转归具有重要意义。Objective To explore the current situation and clinical intervention effect of women with HIV and cervical HPV infection in Shenzhen. Methods From January 1, 2017 to February 1, 2018, HIV-positive women in our hospital were selected as the research subjects. HIV-negative women screened for cervical cancer in our gynecological clinic during the same period were randomly selected as the control group. 550 women in each group were selected. Cervical-related tests, immune cells and H cells were performed on all the subjects. IV viral load measurement, statistics of the status of HPV infection, HPV infection rate and CD4^+ level and HIV RNA quantitative correlation were analyzed. Patients with HIV positive infection and HR-HPV were divided into two groups. One group was treated with anti HIV virus and the other group did not receive any treatment. Patients with HIV negative but HPV positive infection were divided into four groups. The group A was treated with recombinant human interferon A2 B cream plus Bao Fukang suppository;the group B was treated with vaginal interference gel;the group C was treated with vaginal Fubao Kang suppository and group D received no treatment. After 3 courses of treatment, patients in the 4 groups were examined qualitatively and quantitatively for HPV and LCT in 3 months, 6 months and 12 months after drug withdrawal to evaluate the difference of curative effect. Results The HPV infection rate, HR-HPV infection rate, multiple HPV infection rate, cytological abnormality rate and other vaginal diseases infection rate of HIV-positive patients were significantly higher than HIV-negative patients, and there were statistically significant differences in the cervical lesions rate and staging between HIV-positive patients and HIV-negative patients(all P<0.05). The number of CD4^+ cells and CD4^+/CD8^+ in HIV positive patients with HR-HPV infection were significantly lower than those in non-HR-HPV infection group, and the HIV viral load was significantly higher than that in non-HR-HPV infection grou

关 键 词：深圳地区 HIV HPV 现状调查 临床干预 

分 类 号：R711[医药卫生—妇产科学]