宫颈环形电切术联合重组人干扰素a2b对宫颈鳞状上皮内瘤变患者疗效及对阴道微生态的影响  

Efficacy of LEEP Combined with Recombinant Human Interferon a2b on Patients with Cervical Intraepithelial Neoplasia and Its Effects on Vaginal Microecology

作　　者：吴婉如 邓勍 张翠雯 WU Wanru;DENG Qing;ZHANG Cuiwen(Huizhou Central People's Hospital,Guangdong Huizhou 516001,China)

机构地区：[1]广东省惠州市中心人民医院妇产科,广东惠州516001

出　　处：《河北医学》2022年第12期2081-2086,共6页Hebei Medicine

基　　金：广东省医学科学技术研究基金项目,(编号:B2021317)。

摘　　要：目的:观察宫颈环形电切术(LEEP术)联合重组人干扰素a2b凝胶对宫颈鳞状上皮内瘤变(CIN)患者疗效及对阴道微生态的影响。方法:选取2019年6月至2021年12月我院收治的106例CIN患者作为观察对象,随机数字表法简单分为观察组(n=53,LEEP术+重组人干扰素a2b凝胶治疗)和对照组(n=53,LEEP术治疗),连续治疗4周。治疗后3个月,比较两组HPV转阴及阴道微生态恢复情况,比较治疗前、治疗后3个月两组炎性因子及免疫功能水平。结果:治疗后3个月,观察组HPV转阴率(66.04%)及总有效率(96.23%)高于对照组(26.42%及64.15%)(P<0.05)。观察组阴道微生态正常或恢复占比(92.45%)高于对照组(30.38%),阴道分泌物pH(4.19±0.52)及Nugent评分(2.31±0.45)分低于对照组[(4.46±0.50)及(2.93±0.52)分],差异有统计学意义(P<0.05)。两组宫颈局部微生态环境中INF-γ、IL-12、血清CD4^(+)、CD4^(+)/CD8^(+)水平高于治疗前,且两组治疗前后差值组间比较,差异有统计学意义(P<0.05);两组宫颈局部微生态环境中IL-4、TNF-α、血清CD8^(+)水平低于治疗前,且两组治疗前后差值组间比较,差异有统计学意义(P<0.05)。结论:LEEP术+重组人干扰素a2b有利于CIN患者HPV转阴率的提高,降低炎症反应,增强免疫功能,改变预后。Objective:To observe the efficacy of loop electrosurgical excision procedure(LEEP)combined with recombinant human interferon a2b gel on patients with cervical intraepithelial neoplasia(CIN)and its effects on vaginal microecology.Methods:106 patients with CIN who were treated in the hospital between June 2019 and December 2021 were selected as the observation subjects,and they were simply divided into the observation group(n=53,LEEP+recombinant human interferon a2b gel)and the control group(n=53,LEEP)using the random number table method.Both groups were continuously treated for 4 weeks.The HPV negative conversion and vaginal microecology recovery at 3 months after treatment,and inflammatory factors and immune function before treatment and at 3 months after treatment were compared between the two groups.Results:At 3 months after treatment,the HPV negative conversion rate and effective rate were 66.04%and 96.23%in the observation group,which were higher than 26.42%and 64.15%in the control group(P<0.05).The proportion of normal or recovered vaginal microecology(92.45%vs 30.38%)in the observation group was higher while the vaginal secretion pH[(4.19±0.52)vs(4.46±0.50)]and Nugent score[(2.31±0.45)points vs(2.93±0.52)points]were lower(P<0.05)compared to the control group.The levels of INF-γ,IL-12,serum CD4^(+)and CD4^(+)/CD8^(+)in the local cervical microecological environment of the two groups were higher than those before treatment,and the differences before and after treatment in the two groups were statistically significant(P<0.05).The levels of IL-4,TNF-αand serum CD8^(+)in the local cervical microecological environment of both groups were lower than those before treatment,and the differences in the two groups before and after treatment were statistically significant(P<0.05).Conclusion:LEEP+recombinant human interferon a2b is beneficial to increasing the negative conversion rate of HPV,reducing the inflammatory response,enhancing the immune function,and changing the prognosis of patients.

关 键 词：宫颈鳞状上皮内瘤变 宫颈环形电切术 重组人干扰素a2b凝胶 疗效 阴道微生态 

分 类 号：R737.33[医药卫生—肿瘤]