细菌性阴道病及人类乳头状瘤病毒感染与宫颈疾病关系的研究  

Relationship between bacterial vaginosis, human papilloma virus infection and cervical disease

作　　者：蔡美玲[1] 尉文功[1] 俞姗姗 陈海林 CAI Mei-ling;WEI Wen-gong;YU Shan-shan;CHEN Hai-lin(Department of Gynecology,Qingpu Brunch of Zhongshan Hospital Affiliated to Fudan University,Shanghai 201700,China)

机构地区：[1]复旦大学附属中山医院附属青浦分院妇科,上海201700

出　　处：《哈尔滨医科大学学报》2021年第3期299-303,共5页Journal of Harbin Medical University

基　　金：上海市卫计委面上项目(201540055)。

摘　　要：目的探讨细菌性阴道病(bacterial vaginosis, BV)及人类乳头状瘤病毒(human papilloma virus, HPV)感染与宫颈疾病的关系。方法选取2010年4月~2020年4月本院妇科门诊患者1 418例,进行BV、HPV检测,并行液基细胞学检查(TCT)及阴道镜宫颈活检病理检查。结果 1 418例患者中84例TCT细胞学诊断为高度鳞状上皮内病变(HSIL),其中组织病理诊断低度鳞状上皮内病变(LSIL)的患者24例,其余患者均为HSIL,诊断率为71.43%(60/84);共检测HPV 1 418例,其中高危型HPV(high-risk HPV,HR-HPV)(+)342例,感染率24.12%。其分型主要为16型,其次为58型及33型,多重感染者共35例(10.23%),62.86%合并HPV16型感染。HR-HPV(+)组中BV(+)者284例,感染率83.04%(284/342)。BV感染与宫颈病变相关,是宫颈病变的危险因素,但与宫颈病变的分级无关(P>0.05)。1418例患者中,12例宫颈癌均为HR-HPV(+),HR-HPV感染与高度宫颈病变相关(P<0.05)。结论 BV与宫颈病变相关,但与宫颈病变分级无关,HR-HPV感染与高度上皮内病变相关。Objective To investigate the relationship between bacterial vaginosis(BV), human papilloma virus infection(HPV) and cervical diseases. Methods A total of 1 418 patients from the gynecological clinic of our hospital from April 2010 to April 2020 were selected for BV, HPV testing, liquid-based cytologic test(TCT) and colposcopy cervical biopsy pathological examination. Results A total of 1 418 patients underwent biopsy pathology. Among them, 84 cases were diagnosed as HSIL by TCT. Among them, 24 cases were diagnosed as low-grade disease by histopathology, and the others were as high-grade disease by histopathology. The diagnosis rate was 71.43%(60/84). Among 1 418 cases, including 342 cases of HR-HPV(+), and the infection rate was 24.12%. The main classification was type 16, followed by type 58 and type 33. There were 35 cases(10.23%) with multiple infections, and 62.86% were combined with HPV16 infection. In the HR-HPV(+) group, there were 284 BV(+) cases, and the infection rate was 83.04%(284/342). BV infection was related to cervical lesions and was a risk factor for cervical lesions, but has nothing to do with the grading of cervical lesions, P>0.05. Among 1 418 patients, 12 cases of cervical cancer were included in high-grade intraepithelial lesions, all of which were HR-HPV(+), HR-HPV infection was related to high-grade cervical lesions, and was related to the grading of cervical lesions. Conclusion BV is related to HR-HPV infection and cervical lesions, but has no correlation with the grading of cervical lesions. HR-HPV infection is related to high-grade intraepithelial lesions.

关 键 词：细菌性阴道病 人类乳头状瘤病毒 宫颈疾病 

分 类 号：R711.3[医药卫生—妇产科学]