高危型HPV感染妇女阴道菌群及子宫颈菌群与子宫颈鳞状上皮内病变的相关性研究  

Study on correlation between vaginal flora and cervical flora and cervical squamous intraepithelial lesions in women with high-risk HPV infection

作　　者：李锐[1] 于波[1] 张杰 侯政瑶 王红梅[1] LI Rui;YU Bo;ZHANG Jie;HOU Zhengyao;WANG Hongmei(Department of Obstetrics and Gynecology,Qingdao Haici Hospital affiliated with Qingdao University(Qingdao Hospital of Traditional Chinese Medicine),Qingdao Shandong 266033,China;Department of Obstetrics and Gynecology,Qingdao Central Hospital,Qingdao Rehabilitation University,Qingdao Shandong 266042,China)

机构地区：[1]青岛大学附属青岛市海慈医院(青岛市中医医院)妇产科,山东青岛266033 [2]康复大学青岛中心医院产科,山东青岛266042

出　　处：《中国妇产科临床杂志》2024年第5期388-391,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：国家自然科学基金(8220112213)。

摘　　要：目的探究高危型人乳头瘤病毒(HR-HPV)感染妇女阴道菌群及子宫颈菌群与子宫颈鳞状上皮内病变(SIL)的相关性。方法选取青岛大学附属青岛市海慈医院(青岛市中医医院)700例HR-HPV感染妇女为研究组,另选同期420例HPV阴性体检者为对照组,比较研究组和对照组阴道和子宫颈菌群分布情况,根据是否发生SIL将研究组患者分为SIL组(n=278)和非SIL组(n=422),比较SIL组、非SIL组阴道和子宫颈菌群分布情况、菌群微生态,分析HR-HPV感染妇女阴道微生态与HR-HPV感染及SIL的相关性。结果研究组阴道和子宫颈乳酸杆菌阴性率、细菌、支原体感染率显著高于对照组(P<0.05);SIL组阴道和子宫颈乳酸杆菌阴性、细菌感染占比显著高于非SIL组(P<0.05);SIL组菌落密度正常率、菌群多样性正常率、乳酸菌为优势菌群占比、p H值≤4.5占比、唾液酸苷酶阴性占比、白细胞酯酶阴性占比显著低于非SIL组(P<0.05),阴道nugent评分显著高于非SIL组(P<0.05);LSIL组菌落密度正常、菌群多样性正常、白细胞酯酶阴性占比显著高于HSIL组(P<0.05),阴道nugent评分显著低于HSIL组(P<0.05);Spearman相关系数分析显示,HR-HPV感染妇女阴道nugent评分与HR-HPV感染和SIL均呈显著正相关(P<0.05)。结论HR-HPV感染妇女阴道菌群及子宫颈菌群均存在病原微生物感染、微生态失调现象,且阴道菌群微生态与SIL呈显著相关性。Objective To explore the correlation between vaginal flora and cervical flora and cervical squamous intraepithelial lesion(SIL)in women with HR-HPV infection.Methods A total of 700 HR-HPV-infected women from Qingdao Haici Hospital affiliated with Qingdao University(Qingdao Hospital of Traditional Chinese Medicine)were selected as the study group,and 420 HPV-negative physical examination data during the same period were selected as the control group.The distribution of vaginal and cervical microflora in the study group and the control group were compared,and the patients in the study group were divided into SIL group(n=278)and non-SIL group(n=422)according to whether SIL occurred.Vaginal and cervical microflora distribution and microflora microecology were compared between SIL group and non-SIL group,and the correlation between vaginal microecology of HR-HPV infected women and HR-HPV infection and SIL was analyzed.Results The negative rate of vaginal and cervical lactobacilli,the infection rate of bacteria and mycoplasma in the study group were significantly higher than those in the control group(P<0.05).The proportion of vaginal and cervical lactobacilli negative and bacterial infection in SIL group was significantly higher than that in non-SIL group(P<0.05).The normal rate of colony density,the normal rate of bacterial diversity,the proportion of lactic acid bacteria as the dominant bacteria,the proportion of pH≤4.5,the proportion of sialidase negative and the proportion of leucocyte esterase negative in SIL group were significantly lower than those in non-SIL group(P<0.05),and the vaginal Nugent score was significantly higher than that in non-SIL group(P<0.05).The proportion of normal colony density,normal flora diversity and negative leukocyte esterase in LSIL group was significantly higher than that in HSIL group(P<0.05).The vaginal Nugent score was significantly lower than that in the HSIL group(P<0.05).Spearman correlation coefficient analysis showed that the vaginal Nugent score of women with HR-HPV infe

关 键 词：人乳头瘤病毒 阴道菌群 子宫颈菌群 鳞状上皮内瘤变 相关性 

分 类 号：R737.33[医药卫生—肿瘤]