人乳头瘤病毒感染患者阴道菌群分布及宫颈局部免疫功能变化的分析  

Distribution of vaginal flora and changes of cervical local immune function in patients with HPV infection

作　　者：江海燕 周燕[2] 陈晓玲 JIANG Haiyan;ZHOU Yan;CHEN Xiaoling(Department of Gynecology,Quzhou Maternal and Child Health Hospital,Quzhou 324000,Zhejiang,China;Department of Gynecology,Quzhou People's Hospital,Quzhou 324000,Zhejiang,China)

机构地区：[1]衢州市妇幼保健院妇科,浙江衢州324000 [2]衢州市人民医院妇科,浙江衢州324000

出　　处：《中国性科学》2022年第4期83-87,共5页Chinese Journal of Human Sexuality

基　　金：浙江省医药卫生科技计划项目(2018KY880)。

摘　　要：目的统计分析人乳头瘤病毒(HPV)感染患者阴道菌群的分布情况,并观察其宫颈局部免疫功能指标变化。方法选取2018年6月至2020年6月衢州市妇幼保健院收治的156例HPV感染患者作为研究对象,将其中宫颈活检正常患者纳入HPV阳性组(n=31),宫颈低级别上皮内瘤变(LSIL)患者纳入LSIL组(n=36),宫颈高级别上皮内瘤变(HSIL)患者纳入HSIL组(n=49),宫颈癌患者纳入宫颈癌组(n=40);另将同期52例HPV阴性且宫颈活检正常女性纳入对照组。比较各组的阴道菌群分布、宫颈局部免疫指标与炎症因子指标水平。结果宫颈癌组、HSIL组、LSIL组、HPV阳性组的乳酸杆菌异常占比、衣原体及解脲支原体检出率、细菌性阴道病占比与对照组比较,差异具有统计学意义(P<0.05),但滴虫及真菌的检出率与对照组比较,差异无统计学意义(P>0.05);宫颈癌组、HSIL组、LSIL组的CD4^(+)/CD8^(+)低于对照组,HSIL组、LSIL组的分泌型免疫球蛋白A(SIgA)水平高于对照组,宫颈癌组的SIgA水平低于HPV阳性组、对照组(P<0.05);宫颈癌组、HSIL组、LSIL组的白介素-2(IL-2)、干扰素-γ(INF-γ)低于对照组,白介素-10(IL-10)高于对照组,差异具有统计学意义(P<0.05)。结论阴道菌群失衡、宫颈局部免疫功能减退与HPV感染关系密切,二者是诱发宫颈癌的重要因素。Objective To statistically analyze the distribution of vaginal flora in patients with human papilloma virus(HPV)infection,and observe changes in cervical local immune function indexes.Methods 156 patients with HPV infection from June 2018 to June 2020 admitted to Quzhou Maternal and Child Health Hospital were retrospectively analyzed.Among them,cervical HPV-positive patients with normal cervix were classified into HPV-positive group(n=31),and patients with low-grade cervical intraepithelial neoplasia(LSIL)were classified included in the LSIL group(n=36),patients with high-grade cervical intraepithelial neoplasia(HSIL)were included in the HSIL group(n=49),patients with cervical cancer were included in the cervical cancer group(n=40),and 52 cases with normal HPV-negative cervical biopsy in the same period were selected as the control group.The vaginal flora distribution,cervical local immune index and inflammatory factor index levels of the above five groups were compared.Results There were significant differences in the detection rates of abnormal lactobacillus,chlamydia,ureaplasma urealyticum and bacterial vaginosis in cervical cancer group,HSIL group,LSIL group and HPV-positive group compared with the control group(P<0.05),but there was no significant difference in the detection rates of trichomonas and fungi in cervical cancer group,HSIL group,LSIL group and HPV positive group compared with the control group(P>0.05).The level of CD4^(+)/CD8^(+) in cervical cancer group,HSIL group and LSIL group was lower than that in control group,the level of secretory immunoglobulin A(SIgA)in HSIL group and LSIL group was higher than that in control group,and the level of SIgA in cervical cancer group was lower than that in HPV-positive group and control group(P<0.05).The interleukin-2(IL-2)and interferon-γ(INF-γ)levels in cervical cancer group,HSIL group and LSIL group were lower than those in control group,while the interleukin-10(IL-10)level were higher than that in control group,with statistical significance(P<0.05).Con

关 键 词：人乳头瘤病毒 感染 阴道菌群 免疫功能 

分 类 号：R711[医药卫生—妇产科学]