HPV及阴道微环境对下生殖道多中心上皮内病变的交互作用研究  

Interaction of HPV and vaginal microecology on polycentric intraepithelial lesions of the lower genital tract

作　　者：邵亚雯 蔺茹[1] 冉婕[1] 白岩[2] SHAO Yawen;LIN Ru;RAN Jie;BAI Yan(Centre for Cervical Cancer Prevention and Treatment,Gansu provincial Maternal and Child Health Hospital/Gansu Provincial Central Hospital,Gansu Lanzhou 730050,China;Section I of Endoscopy Center,Gansu provincial Maternal and Child Health Hospital/Gansu Provincial Central Hospital,Gansu Lanzhou 730050,China)

机构地区：[1]甘肃省妇幼保健院甘肃省中心医院宫颈癌防治中心,甘肃兰州730050 [2]甘肃省妇幼保健院甘肃省中心医院内镜中心一部,甘肃兰州730050

出　　处：《中国妇幼健康研究》2023年第6期82-88,共7页Chinese Journal of Woman and Child Health Research

基　　金：甘肃省中医药管理局(GZKP-2021-23)。

摘　　要：目的探讨人乳头瘤病毒(HPV)及阴道微环境失衡对下生殖道多中心上皮内病变的影响及交互作用分析。方法选取2021年1月至12月甘肃省妇幼保健院行阴道镜检查的HPV阳性且经病理组织学诊断为下生殖道多中心病变的296人为病例组,选取同期HPV阳性且组织病理学结果为慢性宫颈炎/宫颈息肉患者共343人为对照组。以多因素Logistic回归分析确定HPV及阴道微生态对下生殖道多中心病变的影响;以相乘模型分析细菌性阴道病(BV)与HPV对多中心病变的交互作用。结果HPV16/18型、多重HPV感染、持续HPV感染、BV感染均是发生下生殖道多中心病变的危险因素,其OR值及95%CI分别为1.361(1.132~1.637)、1.556(1.272~1.901)、2.046(1.673~2.503)、2.153(1.031~4.497);交互作用分析显示HPV16/18型阳性且BV阳性患者发生多中心病变风险升高(OR=3.529,95%CI:2.103~5.921),二者具备相乘交互作用(OR=1.755,95%CI:1.322~2.330);多重型别HPV感染且BV阳性者发生多中心病变风险升高(OR=3.767,95%CI:2.126~6.674),二者具备相乘交互作用(OR=1.558,95%CI:1.159~2.095);持续HPV感染且BV阳性者多中心病变风险升高(OR=6.050,95%CI:3.337~10.969),二者具备相乘交互作用(OR=1.885,95%CI:1.389~2.560)。结论HPV与阴道微环境对于下生殖道多中心病变具有交互作用影响,对于HPV阳性者应密切关注阴道微环境变化,对于细菌性阴道病应给予积极治疗。Objective To investigate effects of human papillomavirus(HPV)and vaginal microecology imbalance on polycentric intraepithelial lesions in female lower genital tract and analyze their interactions.Methods A total of 296 HPV-positive patients who underwent colposcopy and were diagnosed as polycentric intraepithelial lesions in the lower reproductive tract conformed by histopathology in Gansu Provincial Maternal and Child Health Hospital from January to December 2021 were selected as case group,and 343 HPV-positive patients with chronic cervicitis/cervical polyps conformed by histopathology during the same period were selected as control group.Multivariate Logistic regression analysis was used to investigate effects of HPV infection and vaginal microecology on polycentric intraepithelial lesions of the lower reproductive tract.The multiplicative model was used to analyze interactions of bacterial vaginosis(BV)and HPV infection on the polycentric intraepithelial lesions.Results HPV16/18 genotype,multiple HPV infection,persistent HPV infection and BV were all risk factors for polycentric intraepithelial lesions of the lower genital tract,and their OR values and 95%CI were 1.361(1.132-1.637),1.556(1.272-1.901),2.046(1.673-2.503)and 2.153(1.031-4.497)respectively.The interaction analysis showed that those patients with positive HPV16/18 infection and BV increased risk of polycentric intraepithelial lesions(OR=3.529,95%CI:2.103-5.921),they had multiplicative interactions on polycentric intraepithelial lesions(OR=1.755,95%CI:1.322-2.330),those patients with multiple types of HPV infection and positive BV increased risk of polycentric intraepithelial lesions(OR=3.767,95%CI:2.126-6.674),and they had multiplicative interactions on polycentric intraepithelial lesions(OR=1.558,95%CI:1.159-2.095),those patients with persistent HPV infection and positive BV increased risk of polycentric intraepithelial lesions(OR=6.050,95%CI:3.337-10.969),and they exerted multiplicative interactions on polycentric intraepithelial lesions(OR=1.88

关 键 词：人乳头瘤病毒 阴道微环境 下生殖道多中心上皮内病变 交互作用 

分 类 号：R173[医药卫生—妇幼卫生保健]