摘要
目的探讨中、晚期妊娠合并宫颈上皮内瘤变（CIN）患者高危型（HR）HPV感染的情况。方法选择2007年8月1日至2010年2月28日在首都医科大学附属北京妇产医院产科门诊进行孕期检查的孕13～32周、签署知情同意书后经三阶梯筛查并宫颈活检诊断为宫颈炎的患者21例及CIN的患者147例（其中CINI68例、CINⅡ37例、CINIII42例），采用第2代杂交捕获试验（HC-II）检测妊娠合并宫颈炎及CIN患者的HR—HPVDNA载量，并行对数（log10）转换。168例患者均随访至产后3～6个月。观察妊娠合并宫颈炎及不同级别CIN患者HR—HPV阳性率、产后3～6个月HR—HPV自然转阴率及孕期和产后3～6个月HR—HPVDNA载量变化[用M（P25、P75）表示]。结果（1）孕期HR—HPV阳性率：妊娠合并CIN III、II、I及宫颌炎患者HR—HPV阳性率分别为98％（41／42）、86％（32／37）、76％（52／68）及62％（13／21），妊娠合并不同级别CIN及宫颈炎患者HR—HPV阳性率比较，差异有统计学意义（P=0．002）。（2）产后3～6个月HR—HPV自然转阴率：妊娠合并宫颈炎及不同级别CIN患者产后3～6个月HR—HPV自然转阴率CIN III为5％（2／41）、CIN II为47％（15／32）、CINI为52％（27／52）及宫颈炎为10／13，妊娠合并宫颈炎及不同级别CIN患者产后3～6个月HR—HPV自然转阴率比较，差异也有统计学意义（P=0．000）。（3）HR—HPVDNA载量：妊娠合行宫颈炎及不同级别CIN患者孕期HR—HPVDNA载量CIN III为2．02ng／L（1．53、2．67ng／L），CINII为1．94ng/L（0．75、2．75ng／L），CINI为2．04ng／L（0．08、2．95ng/L），宫颈炎为1．98．g／L（-0．07、2．47ng／L），妊娠合并宫颈炎及不同级别CIN患者孕期HR—HPVDNA载量比较，差异无统计学意义（P=0．719）；产后3～6个月复查时，HR—HPVDNA载量CINIU为1．55ng／L（0．90、2．10ng／L），显著高于CIN II的0．09ng／L（-0．69、1．74ng／L
Objective To investigate the relationship between cervical intraepithelial neoplasia （CIN） and high-risk （HR）HPV infetion among late pregnant women. Methods From Aug. 2007 to Feb. 2010, 168 women at 13 to 32 gestational weeks undergoing prenatal examination in Beijing Obstetrics and Gynecology Hospital went through three stage cervical disease screening, including 21 women with cervicitis and 147 women with CIN （42 women with CIN III , 37 women with CIN II and 68 women with CIN I ）. Hybrid capture assay version II （ HC- II ） test was used to measure HR-HPV DNA load, and the logarithmic transtormation （log10） was performed. All 168 women were followed up to postpartum 3 - 6 months. HR-HPV infections rates of cervicitis and different CIN, the rate of HR-HPV infection turned naturally negative at postpartum of 3 to 6 months, and HR-HPV load at pregnancy and 3 - 6 months postpartum were observed. Results （ 1 ） HR-HPV infection rate： CIN III, II , I and eervicitis pregnant women＇s HR-HPV positive infection rates were 98% （41/42）, 86% （32/37）, 76% （52/68）and 62% （ 13/21 ） respectively, which reached statistical difference （ P = 0. 002 ）. （ 2 ） HR-HPV naturally negative ： the rate of pregnant women with different levels of CIN who turned HR-HPV naturally negative within 3 - 6 months of postpartum were CIN III 5% （2/41） ,CIN II 47% （15/32） ,CIN I 52 % （27/52） and cervicitis 10/13, which also reached statistical difference among those four groups （ P = 0. 000）. （ 3 ） HR-HPV load ： pregnant women with different grade of CIN and eervicitis HR-HPV DNA load were CIN III 2. 02 ng/L （ 1.53, 2. 67 ng/L）, CIN II 1.94 ug/L （0. 75,2. 75 ng/L）, CIN I 2. 04 ng/L （0. 08,2.95 ng/L） and eervicitis 1.98 ng/L（ -0. 07,2.47 ng/L）. There was no significantly different HPV load in women with cervicitis and different CIN （ P = 0. 719 ） . At 3 - 6 months postpartum, HR-HPV load was CIN m 1.55 ng/L（0. 90, 2. 10 ng/L）, which was significantly hig
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2012年第8期598-602,共5页
Chinese Journal of Obstetrics and Gynecology
基金
基金项目：北京市科技计划（D0906008040391）
关键词
妊娠并发症
肿瘤
宫颈上皮内瘤样病变
乳头状瘤病毒感染
Pregnancy complications,neoplastic
Cervical intraepithelial neoplasia
Papillomavirus infections
