单一、多重高危型人乳头瘤病毒感染女性下生殖道菌群微生态的临床特征  

Clinical characteristics of lower genital tract microbiota in female patients with single,multiple high-risk human papillomavirus infections

作　　者：易彬彬 刘丽丹 贾奕娟 YI Bin-bin;LIU Li-dan;JIA Yi-juan(Wuhan Integrated Traditional Chinese and Western Medicine Hospital(Wuhan First Hospital),Wuhan,Hubei 430000,China)

机构地区：[1]武汉市中西医结合医院(武汉市第一医院)妇科病区,湖北武汉430000

出　　处：《中华医院感染学杂志》2024年第18期2774-2779,共6页Chinese Journal of Nosocomiology

基　　金：武汉市卫生健康委科研基金资助项目(WX18D21)。

摘　　要：目的探讨单一、多重高危型人乳头瘤病毒(HR-HPV)感染女性下生殖道菌群微生态的临床特征。方法选取2022年1月-2023年12月于武汉市中西医结合医院行宫颈HR-HPV筛查阳性的患者93例,根据HR-HPV感染情况分为单一HR-HPV感染组72例和多重HR-HPV感染组21例,另选取HR-HPV阴性的受检者452例作为对照组,所有受检者采集宫颈脱落细胞标本,采用聚合酶链式反应(PCR)荧光探针法进行宫颈HR-HPV分型检测,采集受检者的阴道分泌物标本检测细菌性阴道炎(BV)、滴虫性阴道炎(TV)、外阴阴道假丝酵母菌病(VVC)、解脲脲原体(UU)、沙眼衣原体(CT)的感染情况。结果多重HR-HPV感染组的白细胞计数阳性率、pH值>4.5阳性率高于单一HR-HPV感染组(P<0.05);单一HR-HPV感染组与多重HR-HPV感染组的BV、TV、UU、CT阳性率比较差异无统计学意义;菌群多样性异常、白细胞计数阳性、pH值>4.5、BV阳性、TV阳性、UU阳性、CT阳性与多重HR-HPV感染具有相关性(P<0.05);菌群多样性异常、TV阳性、UU阳性、CT阳性与单一HR-HPV感染具有相关性(P<0.05)。结论HR-HPV感染与下生殖道菌群微生态失调密切相关,且与BV、TV、UU、CT感染有关。多重HR-HPV感染较单一HR-HPV感染更易增加白细胞计数以及阴道弱酸性改变。OBJECTIVE To explore the clinical characteristics of lower genital tract microbiota in female patients with single,multiple high-risk human papillomavirus(HR-HPV)infections.METHODS Totally 93 patients who were positive for screening of cervical HR-HPV in Wuhan Integrated Traditional Chinese and Western Medicine Hospital from Jan 2022 to Dec 2023 were enrolled in the study and were divided into the single HR-HPV infection group with 72 cases and the multiple HR-HPV infection group with 21 cases according to the status of HR-HPV infection,meanwhile,452 participants who were tested negative for HR-HPV were chosen as the control group.The cervical exfoliated cell samples were collected from all of the subjects.The subtypes of cervical HR-HPV were detected by polymerase chain reaction(PCR)fluorescence probe,the vaginal secretion specimens were collected to detect Bacterial vaginitis(BV),Trichomonas vaginitis(TV),Vulvovaginal candidiasis(VVC),Ureaplasma urealyticum(UU)infection and Chlamydia trachomatis(CT)infection.RESULTS The positive rate of white blood cell counts and positive rate of pH value greater than 4.5 were higher in the multiple HR-HPV infection group than in the single HR-HPV infection group(P<0.05).There were no significant differences in the positive rates of BV,TV,UU and CT between the single HR-HPV infection group and the multiple HR-HPV infection group.There was association between the abnormal diversity of flora,positive white blood cell count,pH value greater than 4.5,positive BV,positive TV,positive UU and positive CT and the multiple HR-HPV infection(P<0.05).There was association between the abnormal diversity of flora,positive TV,positive UU,positive CT and the single HR-HPV infection(P<0.05).CONCLUSION The HR-HPV infection is closely associated with lower genital tract dysbacteriosis and is associated with BV,TV,UU and CT infections.The multiple HR-HPV infection is more likely to lead to the increase of white blood cell counts and change of vaginal faintly acid.

关 键 词：高危型人乳头状瘤病毒 下生殖道 菌群微生态 多重感染 危险因素 

分 类 号：R711[医药卫生—妇产科学]