LEEP联合抗HPV凝胶敷料治疗对HSIL伴HR-HPV感染患者阴道菌群、血清存活蛋白及Ki-67的影响  

Effect of loop electrosurgical excision procedure combined with anti-human papilloma virus gel dressing therapy on vaginal flora,serum survivin,and Ki-67 in patients with high-grade squamous intraepithelial lesions with high-risk human papilloma virus infection

作　　者：肖爽 马立 史昭 杨淑英 XIAO Shuang;MA Li;SHI Zhao;YANG Shuying(Department of the Third Gynecology,Shijiazhuang Maternal and Child Health Hospital,Shijiazhuang 050000,Hebei,China;Department of Gynecology,Hebei Reproductive and Obstetrics Hospital,Shijiazhuang 050000,Hebei,China)

机构地区：[1]石家庄市妇幼保健院妇三科,石家庄050000 [2]河北生殖妇产医院妇科,石家庄050000

出　　处：《中国性科学》2024年第11期70-74,共5页Chinese Journal of Human Sexuality

基　　金：2020年度河北省医学科学研究重点课题计划项目(20201357)。

摘　　要：目的探讨宫颈环形电切术(LEEP)联合抗人乳头瘤病毒(HPV)凝胶敷料治疗对高级别鳞状上皮内病变(HSIL)伴高危型人乳头瘤病毒(HR-HPV)感染患者阴道菌群、血清存活蛋白及Ki-67的影响。方法选取2020年1月至2021年6月石家庄市妇幼保健院收治的275例HSIL伴HR-HPV感染患者作为研究对象,按照随机数字表法分为对照组(n=132)和联合组(n=143)。对照组采用LEEP联合干扰素α-2b凝胶治疗,联合组采用LEEP联合抗HPV凝胶敷料治疗。比较两组阴道菌群和致病菌分布情况、阴道微生态情况、血清存活蛋白及Ki-67表达水平。结果治疗前,两组乳酸杆菌分布率比较,差异无统计学意义(P>0.05);治疗后,两组乳酸杆菌分布率均升高,且联合组高于对照组(P<0.05)。治疗后,两组菌群溶血葡萄球菌、阴沟肠杆菌、大肠埃希菌、白色假丝酵母菌、阴道加德纳菌分布率均低于治疗前(P<0.05)。治疗后,两组菌群密集度Ⅱ+Ⅲ、多样性Ⅱ+Ⅲ、微生态正常比例均升高,且联合组微生态正常比例高于对照组(P<0.05)。治疗后,两组血清存活蛋白和Ki-67表达均降低,且联合组低于对照组(P<0.05)。结论LEEP联合抗HPV凝胶敷料能够改善HSIL伴HR-HPV感染患者阴道菌群异常分布,可促进阴道微生态平衡,抑制血清存活蛋白和Ki-67过表达,利于患者术后恢复。Objective To investigate the effect of loop electrosurgical excision procedure(LEEP)combined with anti-human papilloma virus(HPV)gel dressing on vaginal flora,serum survivin and Ki-67 in patients with high-grade squamous intraepithelial lesions(HSIL)and high-risk human papilloma virus(HR-HPV)infection.Methods A total of 275 patients with HSIL combined HR-HPV infection admitted to Shijiazhuang Maternal and Child Health Hospital from January 2020 to June 2021 were selected as the study subjects.They were randomly divided into a control group(n=132)and a combination group(n=143)according to the random number table method.The control group was treated with LEEP combined with interferonα-2b gel,and the combined group was treated with LEEP combined with anti HPV gel dressing.The vaginal flora,distribution of pathogenic bacteria,vaginal microecology condition,serum survivin,and Ki-67 expression levels were compared between two groups.Results Before treatment,there was no significant difference in the distribution rate of lactobacilli between the two groups(P>0.05),and after treatment,the distribution rate of lactobacilli in both groups increased,and the combined group was higher than that in the control group(P<0.05).After treatment,the distribution rates of staphylococcus haemolyticus,enterobacter cloacae,escherichia coli,candida albicans and gardnerella vaginalis in the two groups were lower than those before treatment(P<0.05).After treatment,the normal proportions of densityⅡ+Ⅲ,diversityⅡ+Ⅲ,and normal proportion of microecology increased in the two groups,and the normal proportion of microecology in the combined group was higher than that in the control group(P<0.05).After treatment,the expression of serum survivin and Ki-67 decreased in both groups,and the combined group was lower than the control group(P<0.05).Conclusions LEEP combined with anti-HPV gel dressing can improve the abnormal distribution of vaginal flora in patients with HSIL and HR-HPV infection,promote the vaginal microecological balance,inhi

关 键 词：宫颈环形电切术 抗人乳头瘤病毒凝胶敷料 高级别鳞状上皮内病变 高危型人乳头瘤病毒 阴道菌群 存活蛋白 KI-67 

分 类 号：R711[医药卫生—妇产科学]