高危型HPV感染对不孕患者阴道微生态、免疫功能及辅助生殖临床结局的影响  

Effects of high-risk HPV infection of infertile patients on their vaginal microecology,immune function and clinical outcomes of assisted reproduction treatment

作　　者：王宁宁 朱文怡 李生君[1] 张宪军[1] WANG Ningning;ZHU Wenyi;LI Shengjun;ZHAGN Xianjun(Hengshui People's Hospital(Harison International Peace Hospital),Hengshui,Hebei Province,053000)

机构地区：[1]河北省衡水市人民医院(哈励逊国际和平医院),053000

出　　处：《中国计划生育学杂志》2021年第6期1208-1212,共5页Chinese Journal of Family Planning

摘　　要：目的:探究高危型人乳头瘤病毒(HPV)感染对不孕患者阴道微生态变化、免疫功能改变及辅助生殖临床结局的影响。方法:选取2018年1月-2020年1月本院收治的经辅助生殖(ART)鲜胚移植的高危型HPV感染不孕症患者60例为感染组、HPV阴性60例为未感染组。观察两组患者阴道微生态变化、免疫功能、辅助生殖临床结局。结果:感染组乳酸杆菌异常、细菌性阴道炎、衣原体、解脲脲原体感染、阴道微生态失调等发生情况高于未感染组(P<0.05),两组霉菌、支原体、滴虫感染情况无差异(P>0.05);感染组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK低于未感染组,CD8^(+)高于未感染组(P<0.05),两组B细胞无差异(P>0.05),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK与高危型HPV感染存在负相关(P<0.05),CD8^(+)与高危型HPV感染存在正相关(P<0.05),两组CD4^(+)/CD8^(+)分布存在差异,感染组1.11.9分布少于未感染组(P<0.05);两组辅助生殖临床结局上(Gn用量、Gn天数、扳机日内膜、获得成熟卵数量、有效胚胎数、临床妊娠率、活产率、流产率、异位妊娠、种植率)无差异(P>0.05)。结论:高危型HPV感染不影响不孕患者辅助生殖临床结局,但会导致阴道微生态改变及免疫功能失衡紊乱,临床应注意辅助生殖不孕妇女HPV检测。Objective: To explore the effects of high-risk HPV infection of infertile patients on their vaginal microecology, immune function, and clinical outcomes after assisted reproduction treatment(ART). Methods: 60 infertility patients with high risk HPV infection after ART by fresh embryo transplantation were included in group A and 60 infertility patients without high risk HPV infection after ART by fresh embryo transplantation were included in group B from January 2018 to January 2020. The differences of vaginal microecology, the immune function, and the clinical outcomes of the patients in the two groups after ART were observed. Results: The incidences of lactobacillus abnormality, bacterial vaginitis, chlamydia, ureaplasma ureticum infection, and vaginal microecological dysregulation of the patients in group A were significant higher than those of the patients in group B(P<0.05), but there were no differences in the infection rates of mold, mycoplasma, and trichomonas of the patients between the two groups(P>0.05). The values of CD3^(+), CD4^(+), CD4^(+)/CD8^(+) and NK of the patients in group A were significant lower than those of the patients in group B, while the CD8^(+) value of the patients in group A was significant higher(P<0.05). There was no significant difference in B cells value of the patients between the two groups(P>0.05). The values of CD3^(+), CD4^(+), CD4^(+)/CD8^(+), NK of the patients were negatively correlated with their high-risk HPV infection rate(P<0.05), but the CD8^(+) value was positively correlated with their high-risk HPV infection rate(P<0.05). The distribution of CD4^(+)/CD8^(+) of the patients was significant different between the two groups, the rate of distribution the value 1.1-1.9 of CD4^(+)/CD8^(+) of the patients in group A was significant lower than that of the patients in group B(P<0.05).There were no significant differences in the clinical outcomes(dosage and days of GN used,trigger day endometrium situation,number of mature eggs obtained,number of effective embryos,clinical

关 键 词：女性不孕 高危型HPV感染 阴道微生态 免疫功能 辅助生殖临床结局 

分 类 号：R711.6[医药卫生—妇产科学]