高危型人乳头瘤病毒持续感染患者阴道菌群与宫颈局部免疫功能改变分析  

Analysis of changes of vaginal microflora and cervical local immune function in high-risk patients with persistent infection of human papillomavirus

作　　者：黄以吉 陶华 Huang Yiji;Tao Hua(Department of Obstetrics and Gynecology,Liuzhou Maternal and Child Health Care Hospital(Children's Hospital affiliated to Guangxi University of Science and Technology),Liuzhou 545001,China;Haifu Center,Liuzhou Maternal and Child Health Care Hospital(Children's Hospital,Affiliated Maternity Hospital of Guangxi University of Science and Technology),Liuzhou 545001,China)

机构地区：[1]柳州市妇幼保健院(广西科技大学附属妇产医院儿童医院)妇产科,广西柳州545001 [2]柳州市妇幼保健院(广西科技大学附属妇产医院儿童医院)海扶中心,广西柳州545001

出　　处：《实用妇科内分泌电子杂志》2021年第12期5-7,共3页Electronic Journal of Practical Gynecological Endocrinology

基　　金：广西壮族自治区卫生健康委员会科研课题(编号Z20200436)。

摘　　要：目的分析高危型人乳头瘤病毒(HR-HPV)持续感染患者阴道菌群与宫颈局部免疫功能改变的关联。方法选取60例HR-HPV检测阳性且未进展为高级别宫颈上皮内瘤变(LSIL)且阴道微生态检测失衡的宫颈疾病患者设为试验组;另选取同期60例HR-HPV检测阴性的宫颈疾病患者设为对照组。两组均进行、HR-HPV、阴道微生态检测及宫颈局部免疫功能检测。比较两组患者阴道菌群阳性率、阴道微生态失调情况及T淋巴细胞亚群分布情况。结果试验组乳酸杆菌异常、细菌性阴道炎、衣原体、滴虫、解服腺原体阴道菌群阳性率均高于对照组,差异具有统计学意义(P<0.05)。试验组共检出31例阴道微生态失调,占比51.67%;对照组共检出12例阴道微生态失调,占比20.00%。试验组阴道微生态失调占比高于对照组,差异具有统计学意义(χ^(2)=13.084,P<0.05)。试验组CD3^(+)、CD4^(+)水平低于对照组,但CD8^(+)水平高于对照组,差异具有统计学意义(P<0.05)。结论与HR-HPV阴性患者相比,HR-HPV阳性患者的宫颈局部免疫功能相对较低,易引发阴道菌群变化的同时,还会造成阴道微生态失调,进而提高宫颈癌变的发生风险,临床应予以重视并进行及时有效的干预。Objective To analyze the correlation between vaginal microflora and cervical local immune function changes in patients with high-risk human papillomavirus(HR-HPV)infection.Methods 60 patients with cervical disease who were positive for HR-HPV and did not progress to high-grade cervical intraepithelial neoplasia(LSIL)and vaginal microecological detection imbalance were selected as experimental group.Another 60 patients with cervical diseases who were negative for HR-HPV were selected as the control group.All patients underwent HR-HPV,vaginal microecological test and cervical local immune function test.The positive rate of vaginal microflora,the imbalance of vaginal microecology and the distribution of T lymphocyte subsets were compared between the two groups.Results The positive rates of abnormal lactobacillus,bacterial vaginitis,chlamydia,trichomonas and Ureaplasma urealyticum in experimental group were higher than those in control group,and the difference was statistically significant(P<0.05).In the experimental group,31 cases of vaginal microdysbiosis were detected,accounting for 51.67%.In the control group,12 cases of vaginal microdysbiosis were detected,accounting for 20.00%.The proportion of vaginal microbiosis in experimental group was higher than that in control group,and the difference was statistically significant(χ^(2)=13.084,P<0.05).The levels of CD3^(+)and CD4^(+)in the experimental group were lower than those in the control group,but the levels of CD8^(+)were higher than those in the control group,with statistical significance(P<0.05).Conclusion Compared with HR-HPV negative patients,HR-HPV positive patients have relatively low cervical local immune function,which is easy to cause changes in vaginal flora,hut also can cause vaginal microecological disorders,and thereby increase the risk of cervical cancer.Clinical attention should be paid and timely and effective intervention.

关 键 词：高危型人乳头瘤病毒 持续感染 阴道菌群 免疫功能 宫颈癌变 

分 类 号：R737.33[医药卫生—肿瘤]