阴道微生态与高危型人乳头瘤病毒感染的相关性研究  

Study of correlation between vaginal microecology and high-risk human papillomavirus infection

作　　者：胡晓军 张静华 孙娟 王晓林 尤小燕 HU Xiao-jun;ZHAGN Jing-hua;SUN Juan;WANG Xiao-lin;YOU Xiao-yan(Department of Obstetrics and Gynecology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属郑州中心医院妇产科,郑州450000

出　　处：《医药论坛杂志》2025年第5期524-528,534,共6页Journal of Medical Forum

摘　　要：目的探讨阴道微生态与高危型人乳头瘤病毒(high risk human papillomavirus,HR-HPV)感染的相关性,为宫颈病变的防治提供参考依据。方法选取2023年8月—2024年3月至郑州大学附属郑州中心医院进行人乳头瘤病毒检测及阴道微生态检查的2172例患者,排除低危型HPV感染54例,筛查出HR-HPV 592例,将其作为研究组,HPV阴性1526例作为对照组,评估阴道微生态各项指标与HR-HPV感染的相关性,并找出HR-HPV感染的危险因素。结果研究组中过氧化氢、白细胞酯酶、唾液酸苷酶的阳性率分别为85.47%、95.61%、14.36%,均高于对照组。清洁度Ⅲ~Ⅳ度占比63.18%、乳酸杆菌少或无占比80.74%、阴道酸碱度>4.5占比76.01%,均明显高于对照组,差异有统计学意义(P<0.05)。研究组中占比最高的阴道炎为细菌性阴道病(bacterial vaginitis,BV),检出率为14.86%,其次为滴虫性阴道炎(trichomonas vaginitis,TV),检出率为6.42%,两者均高于对照组,外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)的检出率为3.72%,低于对照组,差异有统计学意义(P<0.05)。Logistic二元回归分析发现阳性指标中过氧化氢、白细胞酯酶、唾液酸苷酶、BV及清洁度Ⅲ~Ⅳ是HR-HPV感染的危险因素(P<0.05)。结论阴道微生态异常与HR-HPV感染关系密切,重视阴道微生态的管理,为宫颈病变的防治提供积极有效措施。Objective To investigate the correlation between vaginal microecology and high-risk human papillomavirus(HR-HPV)infection,and to provide a reference basis for the prevention and treatment of cervical lesions.Methods From August 2023 to March 2024,a total of 2172 patients who underwent HPV testing and vaginal micro-ecology examination at Zhengzhou Central Hospital Affiliated to Zhengzhou University were enrolled in this study.Among these patients,54 cases with low-risk HPV infections were excluded.Subsequently,592 cases of HR-HPV infections were identified and designated as the study group,while 1526 cases with negative HPV results were selected as the con-trol group.The present study aimed to evaluate the correlation between various indicators of vaginal microecology and HR-HPV infection and to identify the potential risk factors associated with HR-HPV infection.Results In the study group,the positive rates of hydrogen peroxide,leukocyte esterase and sialidase were 85.47%,95.61%and 14.36%respectively,all of which were higher than those in the control group.The proportion of cleanliness degree II~IV was 63.18%,the proportion of cases with few or no lactobacilli was 80.74%,and the proportion of vaginal pH value>4.5 was 76.01%,all significantly higher than those in the control group,with statistically significant differences(P<0.05).Among the types of vaginitis in the study group,bacterial vaginitis(BV)had the highest proportion,with a detection rate of 14.86%,followed by trichomonas vaginitis(TV),with a detection rate of 6.42%,both of which were higher than those in the control group.The detection rate of vulvovaginal candidiasis(VVC)was 3.72%,lower than that in the control group,and the differences were statistically significant(P<0.05).Logistic binary regression analysis revealed that among the positive indicators,hydrogen peroxide,leukocyte esterase,sialidase,BV and cleanliness degree Ⅲ~Ⅳ were risk factors for HR-HPV infection(P<0.05).Conclusion Abnormal vaginal microecology is closely associated with HR-HPV

关 键 词：阴道微生态 高危型人乳头瘤病毒感染 阴道炎 相关性 

分 类 号：R711.32[医药卫生—妇产科学]