阴道微生物代谢产物及酶异常与女性宫颈病变的相关性研究  

Correlation between abnormal vaginal microbial metabolites and enzymes and cervical lesions in women

作　　者：陈慧萍 何珍媛 鞠增睿 蒲荣 Chen Huiping;He Zhenyuan;Ju Zengrui;Pu Rong(Clinical Laboratory,Huizhou Women and Childrens Hospital Afiliated to Guangdong Medical University(The Second Maternity and Child Health Hospital of Huizhou),Huizhou Guangdong 516000;Clinical Laboratory,Dongguan Third Clinical Medical College of Guangdong Medical University,Dongguan Guangdong 523000,P.R.China)

机构地区：[1]广东医科大学附属惠州妇女儿童医院(惠州市第二妇幼保健院)检验科,广东惠州516000 [2]广东医科大学东莞第三临床医学院检验科,广东东莞523000

出　　处：《中国计划生育和妇产科》2023年第7期42-46,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：东莞市社会发展科技项目(项目编号:20221800900652)。

摘　　要：目的研究阴道微生物代谢产物及酶异常与女性宫颈病变的相关性。方法选取2019年1月至2021年12月在广东医科大学附属惠州妇女儿童医院接受宫颈病变筛查的210例女性作为研究对象,对其进行液基薄层细胞检测(thinprep cytologictest,TCT)、人乳头瘤病毒(human papillomavirus,HPV)定性检测及阴道微生态评价系统检测。根据阴道镜下宫颈活检病理诊断结果将研究对象分为病变组和正常组,并结合TCT、HPV定性检测及阴道微生态评价系统等对数据进行分析,以此探究阴道微生物代谢产物及酶异常与女性宫颈病变的相关性。结果受检女性白细胞酯酶的阳性率最高,为62.9%,胱胺酰蛋白酶的阳性率最低,为5.7%,阴道中过氧化氢(H_(2)O_(2))、唾液酸苷酶及白细胞酯酶可能与高危型人乳头瘤病毒(high risk human papilloma virus,HR-HPV)感染相关(P<0.05),而β-葡糖醛酸糖苷酶、乙酰氨基葡糖苷酶及胱胺酰蛋白酶与HR-HPV感染无明显相关(P>0.05)。阴道中HR-HPV、H_(2)O_(2)、唾液酸苷酶及白细胞酯酶可能与宫颈病变相关(P<0.05),而β-葡糖醛酸糖苷酶、乙酰氨基葡糖苷酶及胱胺酰蛋白酶与宫颈病变无明显相关(P>0.05)。通过多因素Logistic回归分析显示,HR-HPV阳性是宫颈病变的独立危险因素(P=0.002,OR4.216,95%CI1.463-9.101),而唾液酸苷酶阳性和白细胞酯酶阳性与宫颈病变之间关联不存在统计学意义(P>0.05);同时HR-HPV阳性与H_(2)O_(2)阳性、唾液酸苷酶阳性及白细胞酯酶阳性均能使宫颈病变风险增加(P<0.05)。结论除HR-HPV感染外,H_(2)O_(2)、唾液酸苷酶及白细胞酯酶阳性均与女性宫颈病变的发生发展有关,且与HR-HPV感染具有一定的协同作用。Objective To study the correlation between abnormal metabolites and enzymes of vaginal microorganisms and cervical lesions in women.Methods A total of 210 women who were screened for cervical lesions in Huizhou Women and Children's Hospital Affliated to Guangdong Medical University from January 2019 to December 2021 were selected as subjects,thinprep cytologic test(TCT),human papillomavirus(HPV)and vaginal microecological evaluation system were performed.According to the pathological diagnosis results of cervical biopsy under colposcopy,the study subjects were divided into pathological group and normal group,and the data were analyzed in combination with TCT,HPV qualitative detection and vaginal microecological evaluation system,so as to explore the correlation between abnormal vaginal microbial metabolites and enzymes and female cervical lesions.Results The highest positive rate of leucocyte esterase was 62.9%,and the lowest positive rate of cysteine protease was 5.7%.Hydrogen peroxide(H_(2),0_(2)),sialidase and leucocyte esterase in vagina may be associated with high risk human papillomavirus(HR-HPV)infection(P<0.05).However,β-glucuronidase,acetylglucosidase and cysteinase were not associated with HR-HPV infection(P>0.05).HR-HPV,H_(2),0_(2),sialoglycosidase and leucocyte esterase in the vagina may be correlated with cervical lesions(P<0.05),butβ-glucuronidase,acetylaminoglycosidase and cysteinase were not correlated with cervical lesions(P>0.05).Multivariate Logistic regression analysis showed that HR-HPV positive was an independent risk factor for cervical lesions(P=0.02,OR 4.216,95%CI 1.643-9.101).There was no statistical correlation between positive sialidase and leucocyte esterase and cervical lesions(P>0.05).Meanwhile,HR-HPV positive,H_(2),0_(2) positive,sialidase positive and leucocyte esterase positive could increase the risk of cervical lesions(P<0.05).Conclusion In addition to HR-HPV infection,positive H_(2),0_(2),sialidase and leucocyte esterase are related to the occurrence and development of cervi

关 键 词：阴道微生物 代谢产物及酶 宫颈病变 相关性 

分 类 号：R37[医药卫生—病原生物学] R711.32[医药卫生—基础医学]