不同HPV感染亚型对不孕女性阴道微生态及辅助生殖助孕结局的影响  

Effects of different HPV infection subtypes on vaginal microbiome and assisted reproductive outcomes in infertile women

作　　者：刘阳[1] 徐珲[1] 李萍 LIU Yang;XU Hui;LI Ping(Department of Gynecology,Baoji Central Hospital,Shaanxi Baoji 721000,China;Center of Reproductive Medicine,Northwest Maternal and Child Hospital,Shaanxi Xi′an 710000,China)

机构地区：[1]宝鸡市中心医院妇科,陕西宝鸡721000 [2]西北妇幼儿童医院生殖中心,陕西西安710000

出　　处：《中国妇幼健康研究》2024年第11期69-75,共7页Chinese Journal of Woman and Child Health Research

基　　金：宝鸡市中心医院科研基金项目(BZXJJQN20208);2018年度宝鸡市卫生健康委员会科研计划立项课题(201809)。

摘　　要：目的探讨不同人乳头瘤病毒(HPV)感染亚型对不孕女性阴道微生态及辅助生殖(ART)助孕结局的影响。方法选取2020年1月至2022年3月期间于宝鸡市中心医院进行ART助孕的HPV阳性不孕女性190例,对所有患者均进行了HPV分型检查,根据患者感染HPV的不同亚型将其分为高危组(151例)与低危组(39例),选取同期进行ART助孕的HPV阴性不孕女性纳入对照组(95例)。检查患者阴道微生态情况及阴道病原菌感染情况,记录患者ART助孕结局(获卵数、可移植胚胎数及优质胚胎数)和妊娠结局(临床妊娠率、活产分娩率及流产率),并对各组数据进行统计分析。结果高危组、低危组、对照组的H_(2)O_(2)阳性率比较差异无统计学意义(P>0.05);高危组、低危组、对照组的乳酸杆菌、唾液酸苷酶、白细胞酯酶的阳性率及阴道微生态失衡率比较差异均有统计学意义(χ^(2)值分别为7.604、9.086、6.825、8.502,P<0.05);高危组的乳酸杆菌、唾液酸苷酶、白细胞酯酶的阳性率及阴道微生态失衡率均明显高于对照组,经比较差异均有统计学意义(χ^(2)值分别为7.087、9.038、6.767、8.373,P<0.05)。高危组、低危组、对照组的外阴阴道假丝酵母菌病(VVC)、细菌性阴道病(BV)的感染率比较差异均无统计学意义(P>0.05),高危组、低危组、对照组的混合型阴道感染率比较差异有统计学意义(χ^(2)=15.258,P<0.05);高危组的混合型阴道感染率均明显高于低危组和对照组,经比较差异均有统计学意义(χ^(2)值分别为4.808、12.002,P<0.05)。高危组、低危组、对照组患者的获卵数、可移植胚胎数及优质胚胎数比较差异均无统计学意义(P>0.05)。高危组、低危组、对照组患者的临床妊娠率比较差异无统计学意义(P>0.05),三组的活产分娩率和流产率比较差异均有统计学意义(χ^(2)值分别为2.841、2.936,P<0.05);高危组的活产分娩率明显低于对照组,流产率明显高于对Objective To investigate the effects of different human papillomavirus(HPV)infection subtypes on vaginal microbiome and assisted reproductive technology(ART)outcomes in infertile women.Methods A total of 190 infertile women who tested positive for HPV and underwent ART at Baoji Central Hospital from January 2020 to March 2022 were selected.All patients underwent HPV genotyping and were divided into a high-risk group(151 cases)and a low-risk group(39 cases)according to different subtypes of HPV.Infertile women who were HPV-negative and underwent ART during the same period were selected as the control group(95 cases).Vaginal microbiome and vaginal pathogen infections of patients were examined,and the outcomes of ART(number of retrieved oocytes,number of transferable embryos,and number of high-quality embryos)and pregnancy outcomes(clinical pregnancy rate,live birth rate and miscarriage rate)were recorded.Statistical analysis was conducted on the data from each group.Results The differences in the hydrogen peroxide(H_(2)O_(2))positive rates among the high-risk group,low-risk group,and control group were not statistically significant(P>0.05).The positive rates of lactobacillus,sialidase,leukocyte esterase and the rate of vaginal microbiome imbalance among the high-risk group,low-risk group,and control group were statistically significant(χ^(2)values were 7.604,9.086,6.825 and 8.502,respectively,P<0.05).The positive rates of lactobacillus,sialidase,leukocyte esterase and the rate of vaginal microbiome imbalance in the high-risk group were significantly higher than those in the control group,with statistically significant differences(χ^(2)values were 7.087,9.038,6.767 and 8.373,respectively,P<0.05).The differences in the infection rates of vulvovaginal candidiasis(VVC)and bacterial vaginosis(BV)among the high-risk group,low-risk group,and control group were not statistically significant(P>0.05).The differences in the mixed vaginal infection rates among the high-risk group,low-risk group and control group were statist

关 键 词：人乳头瘤病毒 亚型 不孕症 阴道微生态 辅助生殖 助孕结局 

分 类 号：R173[医药卫生—妇幼卫生保健]