阴道微生物群和雌激素及孕激素水平对宫颈病变的影响  

Effects of vaginal microflora and levels of estrogen and progesterone on cervical lesions

作　　者：刘成程[1] 孙慧芹[1] 刘海婷[1] 李健美[1] LIU Chengcheng;SUN Huiqin;LIU Haiting;LI Jianmei(Clinical Laboratory,Zibo Maternal and Child Care Service Centre,Zibo,Shandong 255000,China)

机构地区：[1]淄博市妇幼保健院检验科,山东255000

出　　处：《中国微生态学杂志》2023年第8期965-968,共4页Chinese Journal of Microecology

基　　金：淄博市科技发展计划(2017kj010017)。

摘　　要：目的 研究阴道微生物群、雌激素、孕激素水平与宫颈病变的关系,评价宫颈病变的高危因素,为该类患者的治疗提供参考。方法 选择2021年12月至2022年5月我院首次确诊的宫颈病变患者121例为研究组。全部患者行病理活检,其中宫颈低级别鳞状上皮内病变(LSIL)93例,宫颈高级别鳞状上皮内病变(HSIL)16例,宫颈鳞状细胞癌7例,腺癌5例。随机选取同期筛查无宫颈病变的健康女性100例作为正常对照组。两组对象同时进行阴道微生物群分析、人乳头瘤病毒(HPV)和雌、孕激素水平检测,采用Logistic逐步回归法分析其与宫颈病变的相关性。结果 (1)宫颈病变组患者阴道微生物群异常率(82.64%)显著高于正常对照组(32.00%),其中乳杆菌阳性率(28.93%)显著低于正常对照组(81.00%),阴道菌群密集度异常率(55.37%)显著高于正常对照组(3.00%),阴道菌群多样性异常率(66.12%)显著高于正常对照组(21.00%),HPV感染率(72.73%)显著高于正常对照组(25.00%),差异均有统计学意义(均P<0.05);(2)宫颈病变组患者雌二醇水平显著高于对照组(P<0.05),而孕酮水平差异无统计学意义(P>0.05);(3)二分类Logistic回归分析显示,乳杆菌减少、HPV感染和雌激素水平均为影响宫颈病变的独立危险因素(均P<0.05)。结论阴道微生物群失调(阴道菌群密集度异常、阴道菌群多样性异常、阴道优势菌改变、HPV感染),雌、孕激素水平改变与宫颈病变有密切相关性;同时阴道乳杆菌减少、HPV感染与雌激素水平下降是引起宫颈病变的独立危险因素。Objective To explore the relationship of vaginal microbiota and levels of estrogen and progesterone with cervical lesions,and evaluate the high-risk factors of cervical lesions,providing a reference for the treatment.Methods A total of 121 patients with cervical lesions initially diagnosed in our hospital from December 2021 to May 2022 were selected as the study group.Pathological biopsy examination was performed on 93 cases of low grade squamous intraepithelial lesion(LSIL),16 cases of high grade squamous intraepithelial lesion(HSIL),7 cases of cervical squamous cell carcinoma and 5 cases of adenocarcinoma.A total of 100 healthy women were randomly selected as the normal control group.The vaginal microbiota,human papilloma virus(HPV),and levels of estrogen and progesterone were detected in both groups.Logistic stepwise regression was used to analyze the correlation with cervical lesions.Results(1)Compared with the normal control group,the rate of abnormal microbial flora in cervical lesion group was significantly higher(82.64%vs 32.00%),in which the positive rate of Lactobacillus was significantly lower(28.93%vs 81.00%);the rate of abnormal vaginal flora density was significantly higher(55.37%vs 3.00%),the rate of abnormal diversity of vaginal flora was significantly higher(66.12%vs 21.00%),and the HPV infection rate was significantly higher(72.73%vs 25.00%).The differences were statistically significant(all P<0.05);(2)The level of estradiol in cervical lesion group was significantly higher than that in control group(P<0.05),while that of progesterone was not significant different(P>0.05);(3)Binary logistic regression analysis showed that the reduction of lactic acid bacteria,HPV infection and estrogen level were independent risk factors for cervical lesions(all P<0.05).Conclusion Vaginal microflora disorders(vaginal microflora density abnormal,vaginal microflora diversity abnormal,vaginal dominant bacteria changes,HPV infection),and levels of estrogen and progesterone are closely related to cervical lesions;the

关 键 词：阴道微生物群 雌激素 宫颈病变 HPV感染 

分 类 号：R446.5[医药卫生—诊断学]