高危型HPV感染和宫颈癌前病变与阴道微生态的影响因素分析  

Correlation analysis between high-risk HPV infection and cervical precancerous lesions and vaginal microecology

作　　者：赵仙华 Zhao Xianhua(Clinical laboratory,Danyang city maternal and child health care hospital,Danyang 212300,China)

机构地区：[1]丹阳市妇幼保健院检验科,江苏丹阳212300

出　　处：《实用妇科内分泌电子杂志》2023年第14期102-104,108,共4页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的探究高危型人乳头瘤病毒(HR-HPV)感染和宫颈癌前病变与阴道微生态的影响因素。方法选取250例疑似高危型HPV感染和宫颈癌前病变患者,均实施液基薄层细胞学检查(TCT)、HR-HPV筛查,以病理活检结果为金标准,统计宫颈癌前病变情况。将宫颈鳞状上皮内病变患者作为A组,无宫颈病变且HPV阴性者作为B组,实施阴道微生态检测,分析阴道微生态检测指标。结果250例疑似患者中,宫颈上皮内瘤样病变Ⅰ级69例,宫颈上皮内瘤样病变Ⅱ级54例,宫颈上皮内瘤样病变Ⅲ级40例,正常宫颈组织87例。A组乳酸杆菌、乳酸杆菌功能正常的检出率显著高于B组,差异有统计学意义(P<0.05)。两组试验者菌种多样性呈Ⅱ~Ⅲ级、菌群密集度呈Ⅱ~Ⅲ级、pH<4.5的检出率比较,差异无统计学意义(P>0.05)。A组细菌性阴道病、需氧菌性阴道病发生率均显著高于B组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示:乳酸杆菌占比低、患有细菌性阴道病、需氧菌性阴道病是宫颈癌前病变的危险因素(P<0.05)。结论高危型HPV感染宫颈癌前病变患者的微生态异常的危险因素包括乳酸杆菌占比低、发生细菌性阴道病及需氧菌性阴道病,通过改善阴道微环境有助于预防宫颈病变。Objective To explore the influencing factors of high-risk human papillomavirus(HR-HPV)infection,cervical precancer and vaginal microecology.Methods 250 patients with suspected high-risk HPV infection and cervical prelesions were selected for screening by liquid-based thin layer cytology(TCT)and HR-HPV.The results of pathological biopsy were used as the gold standard to evaluate the cervical prelesions.Patients with cervical squamous intraepithelial lesions were selected as group A,and those with no cervical lesions and HPV negative were selected as group B.Vaginal microecological detection was performed and vaginal microecological detection indexes were analyzed.Results Among the 250 suspected patients,69 cases had grade Ⅰ cervical intraepithelial neoplasia,54 cases had grade Ⅲ cervical intraepithelial neoplasia,40 cases had grade Ⅲ cervical intraepithelial neoplasia,and 87 cases had normal cervical tissue.The detection rate of lactobacillus with normal function in group A was significantly higher than that in group B,with statistical significance(P<0.05).There was no significant difference between the two groups(P>0.05)in the detection rates of bacterial diversity in class Ⅱ~Ⅲ,bacterial density in class Ⅱ~Ⅲ and pH<4.5.The incidence of bacterial vaginosis and aerobic vaginosis in group A was significantly higher than that in group B,with statistical significance(P<0.05).Multivariate Logistic regression analysis showed that low proportion of lactobacillus,bacterial vaginosis and aerobic vaginosis were risk factors for cervical precancerous lesions(P<o.05).Conclusion Risk factors for microecological abnormalities in high-risk HPV patients with cervical precancerous lesions include low proportion of lactobacillus,bacterial vaginosis and aerobic vaginosis.Improving the vaginal microenvironment can help prevent cervical lesions.

关 键 词：宫颈癌前病变 液基薄层细胞学检查 高危型人乳头瘤病毒 阴道微生态 

分 类 号：R737.33[医药卫生—肿瘤] R711[医药卫生—临床医学]