探讨血清CD4水平联合阴道微生态环境指标与老年女性人类乳头瘤病毒感染的关系  

Relationship between serum CD4 level combined with vaginal microecological environment indexes and human papillomavirus infection in elderly women

作　　者：叶扬英 张忠源 杨淑珍 Ye Yangying;Zhang Zhongyuan;Yang Shuzhen(Department of Physical Examination,First Hospital of Nanping City,Nanping,Fujian,353000,P.R.China;Departmentof Laboratory,First Hospital of Nanping City,Nanping,Fujian,353000,P.R.China)

机构地区：[1]南平市第一医院体检科,福建南平353000 [2]南平市第一医院检验科,福建南平353000

出　　处：《老年医学与保健》2022年第5期1010-1014,共5页Geriatrics & Health Care

摘　　要：目的 本研究旨在探索T细胞血清学标志物以及阴道微生态环境指标与老年女性人类乳头瘤病毒(HPV)感染的关系。方法 选取2021年6月1日-2022年6月1日在南平市第一医院门诊进行高危型HPV检查的老年女性患者。根据检测结果将患者分为高危型HPV阳性组和高危型HPV阴性组。观察阴道微生态环境指标值(念珠菌、滴虫、细菌、阴道清洁度、 pH值、唾液酸苷酶、过氧化氢、白细胞酯酶)和T细胞血清标志物水平(CD3、 CD4、 CD8);采用单因素和多因素Logistic回归分析筛选高危型HPV感染的危险因素;采用受试者工作特征(receiver operating characteristic,ROC)曲线评估临床变量对高危型HPV的诊断效能。结果 高危型HPV阳性组细菌感染(P=0.003)以及阴道清洁度异常(P=0.001)患者比例高于高危型HPV阴性组。高危型HPV阳性组阴道唾液酸苷酶阳性(P=0.001)患者比例高于高危型HPV阴性组。高危型HPV阳性组血清CD4水平(P=0.001)和CD8水平(P=0.008)均低于高危型HPV阴性组。阴道清洁度异常(OR=2.18,P=0.034)、阴道细菌感染(OR=4.44,P=0.005)、血清CD4降低(OR=3.16,P=0.001)、血清CD8降低(OR=1.53,P=0.004)是高危型HPV感染的危险因素。细菌感染(OR=2.36,P=0.016)、血清CD4降低(OR=1.83,P=0.002)是高危型HPV感染的独立危险因素。ROC曲线表明,阴道细菌感染曲线下面积为0.54 (P=0.034);血清CD4水平曲线下面积为0.61 (P=0.008);血清CD4水平联合细菌感染曲线下面积为0.73 (P=0.004)。结论 在阴道微生态环境和血清抗原分化簇指标中,阴道细菌感染、血清CD4降低是老年女性感染高危HPV的独立危险因素。Objective To explore the relationship between T cell serological markers and vaginal microecological environment indexes and human papillomavirus(HPV) infection in elderly women.Methods Elderly female patients who underwent high-risk HPV examination in Outpatient Department of First Hospital of Nanping City from June 1,2021 to June 1,2022 were selected.According to the test results,they were divided into high-risk HPV positive group and high-risk HPV negative group.Vaginal microecological environment indexes(Candida,trichomonas,bacteria,vaginal cleanliness,pH,sialidase,hydrogen peroxide,leucocyte esterase) and T cell serum markers(CD3,CD4,and CD8) were detected.Univariate and multivariate Logistic regression analysis were used to screen the risk factors of high-risk HPV infection.The receiver operating characteristic(ROC) curve was used to evaluate the diagnostic efficacy of clinical variables for high-risk HPV.Results The proportion of patients with bacterial infection(P=0.003) and abnormal vaginal cleanliness(P=0.001) in the high-risk HPV-positive group was higher than that in the high-risk HPV-negative group,and the proportion of patients with positive vaginal sialidase was higher than that in the high-risk HPV negative group(P=0.001).The levels of serum CD4(P=0.001) and CD8(P=0.008) in the high-risk HPV positive group were lower than those in the high-risk HPV negative group.Abnormal vaginal cleanliness(OR=2.18,P=0.034),vaginal bacterial infection(OR=4.44,P=0.005),decreased serum CD4(OR=3.16,P=0.001) anddecreased serum CD8(OR=1.53,P=0.004) were risk factors for high-risk HPV infection.Bacterial infection(OR=2.36,P=0.016) and decreased serum CD4(OR=1.83,P=0.002) were independent risk factors for high-risk HPV infection.ROC curve showed that the area under the curve(AUC) of vaginal bacterial infection was 0.54(P=0.034),the AUC of serum CD4 level was 0.61(P=0.008) and the AUC of serum CD4 level combined with vaginal bacterial infectionwas 0.73(P=0.004).Conclusion Among the indexes of vaginal microecological envi

关 键 词：老年 人类乳头瘤病毒 危险因素 微生态环境 

分 类 号：R711[医药卫生—妇产科学]