高危型人乳头瘤病毒感染对妊娠结局及阴道微生态环境的影响  

Impact of high⁃risk HPV infections on pregnancy outcomes and vaginal microenvironment

作　　者：李雅玲 牛刚[2] 王伟[2] LI Yaling;NIU Gang;WANG Wei(Department of Obstetrics and Gynecology,Mingshan Branch,the First Affiliated Hospital,Chengdu Medical College,People′s Hospital of Mingshan District Ya′an,Ya′an 625100,China;不详)

机构地区：[1]成都医学院第一附属医院名山分院(雅安市名山区人民医院)妇产科,四川雅安625100 [2]中山大学附属第一医院妇科,广州510080

出　　处：《实用医学杂志》2024年第15期2138-2141,共4页The Journal of Practical Medicine

基　　金：广东省自然科学基金项目(编号:2023A1515012214)。

摘　　要：目的探讨高危型人乳头瘤病毒(HR-HPV)感染对妊娠结局及阴道微生态的影响。方法选取于成都医学院第一附属医院名山分院进行产检的128例孕妇为研究对象。均进行阴道微生态及HR-HPV检测,采用单因素分析及多元线性回归分析明确孕妇HR-HPV感染的相关因素,研究HR-HPV感染对孕妇妊娠结局及阴道微生态的影响。结果感染组49例中16型HPV 30例(61.22%),18型HPV13例(26.53%),31、33、51、52、53、58型各1例。单因素分析显示HR-HPV感染与初次性行为年龄、避孕套使用、性伴侣数量、生殖道炎症、吸烟史显著相关(P<0.05)。多因素分析显示初次性行为年龄≤20岁、合并生殖道炎症、多个性伴侣、吸烟史为HR-HPV感染的独立危险因素,使用避孕套为HR-HPV感染的保护因素。孕妇乳酸杆菌数量、念珠菌感染以及阴道清洁度在两组间有显著差异(P<0.05)。HR-HPV感染组自然流产率以及胎儿生长受限发生率显著高于未感染组(P<0.05)。结论孕妇HR-HPV感染与过早性行为、性伴侣数量、生殖道炎症、吸烟等因素密切相关。妊娠期HR-HPV感染可致阴道微生态环境变化,并致不良妊娠结局。Objective To explore the impact of HR-HPV infection on pregnancy outcomes and vaginal microbiota.Methods 128 pregnant women who underwent prenatal examinations at Mingshan Branch of the First Affiliated Hospital of Chengdu Medical College were selected as the research subjects.Both vaginal microbiota and HR-HPV testing were conducted,and single factor analysis and multiple linear regression analysis were used to identify the relevant factors of HR-HPV infection in pregnant women.The impact of HR-HPV infection on pregnancy outcomes and vaginal microbiota was studied.Results Among the 49 cases in the infection group,30 cases contracted with type 16 HPV,accounting for 61.22%,13 type 18 HPV,accounting for 26.53%,and 1 type 31,33,51,52,53,and 58,respectively.Univariate analysis showed that HR-HPV infections were significantly correlated with age of first sexual activity,condom use,number of sexual partners,reproductive tract inflammation,and smoking history(P<0.05).Multivariate analysis showed that age of first sexual activity≤20 years,concurrent reproductive tract inflammation,multiple sexual partners,and smoking history were independent risk factors for HR-HPV infection,while condom use was an independent protective factor for HR-HPV infection.There were significant differences in the number of lactobacilli,candida infections,and vaginal cleanliness between the two groups(P<0.05).The incidence of spontaneous abortion and fetal growth restriction in the HR-HPV-infected group was significantly higher than that in the HR-HPV-uninfected group(P<0.05).Conclusions Pregnant women with HR-HPV infections are closely related to factors such as premature sexual conduct,number of sexual partners,reproductive tract inflammation,and smoking.Infections with HR-HPV during pregnancy can cause changes in the vaginal microenvironment and lead to adverse pregnancy outcomes.

关 键 词：高危型HPV感染 妊娠结局 阴道微生态环境 

分 类 号：R714[医药卫生—妇产科学]