HPV感染的HSIL患者阴道微生态特征与健康人群对照分析  

Comparative Analysis of Vaginal Microecological Characteristics in HSIL Patients with HPV Infection and Healthy Individuals

作　　者：温颖能 WEN Yingneng(Fujian Medical University Affiliated Nanping First HospitalHealth Examination Department,Nanping 353000,China)

机构地区：[1]福建医科大学附属南平第一医院健康体检科,福建南平353000

出　　处：《中华灾害救援医学》2024年第7期806-808,共3页Chinese Journal of Disaster Medicine

摘　　要：目的探索人乳头瘤病毒(Human Papillomavirus,HPV)感染的高级别宫颈上皮内瘤变(High-grade Squamous Intraepithelial Lesion,HSIL)患者阴道微生态特征。方法纳入2020年6月至2023年6月在福建医科大学附属南平第一医院就诊的60例HPV(+)且阴道镜下活检提示HSIL女性患者为观察组,同期体检的60例HPV(-)且宫颈细胞学检查正常的女性为对照组。比较HPV检出情况,以及组间阴道菌群的检出和阴道微生态异常的情况。结果60例HPV感染HSIL患者中,HPV感染最常见的类型为HPV16(38.33%,23/60),其次分别为HPV52(23.33%,14/60)、HPV58(18.33%,11/60)、HPV18(11.67%,7/60)、HPV33(8.33%,5/60)。两组滴虫性阴道炎和外阴阴道念珠菌病检出率无明显差异(P>0.05);观察组患者细菌性阴道病、解脲支原体(+)、人型支原体(+)、衣原体(+)及乳酸杆菌(-)检出率均显著高于对照组(P<0.05),差异有统计学意义。两组阴道微生物中唾液酸苷酶(+)和白细胞酯酶(+)检出率无明显差异(P>0.05);观察组患者阴道pH>4.5和H2O_(2)(+)检出率均显著高于对照组(P<0.05),差异有统计学意义。结论阴道微生态失衡在HPV感染合并HSIL的患者中普遍存在,临床上应及时阴道清除致病菌,调节阴道菌群的多样性和平衡,积极治疗HPV感染。Objective To explore the vaginal microecological characteristics of HSIL patients with HPV infection.Methods 60 HPV-positive women diagnosed with HSIL through vaginal biopsy at Nanping First Hospital,Fujian Medical University from June 2020 to June 2023,were enrolled as the observation group.Concurrently,60 HPV-negative women with normal cervical cytology findings from our hospital's health examinations were included as the control group.We compared HPV detection rates,vaginal flora profiles,and vaginal microecolog ical abnormalities between the groups.Results Among the 60 HPV-infected HSIL patients,the most common HPV types were HPV16(38.33%,23/60),followed by HPV52(23.33%,14/60),HPV58(18.33%,11/60),HPV18(11.67%,7/60),and HPV33(8.33%,5/60).There was no significant difference in the detection rates of trichomoniasis vaginitis and vulvovaginal candidiasis between the two groups(P>0.05).However,patients in the observation group showed significantly higher rates of bacterial vaginosis,chlamydia trachomatis(+),Ureaplasma urealyticum(+),Mycoplasma hominis(+),and lactobacillus compared to the control group(P<0.05).There was no significant difference in the detection rates of sialidase(+)and leukocyte esterase(+)in vaginal microbiota between the two groups(P>0.05).However,the observation group had significantly higher rates of vaginal pH>4.5 and hydrogen peroxide(H2O_(2)+)compared to the control group(P<0.05).Conclusion Vaginal microecological imbalance is common among HPV-infected HSIL patients,highlighting the importance of timely pathogen clearance,adjustment of vaginal microbiota diversity and balance,and active treatment of HPV infection in clinical practice.

关 键 词：人乳头瘤病毒16 阴道镜检查 阴道病 细菌性 阴道涂片 

分 类 号：R711[医药卫生—妇产科学]