摘要
目的探讨宫颈高危型人乳头瘤病毒(HR-HPV)持续和非持续感染与阴道微生态环境及宫颈病变的相关性,为HPV防治提供基础依据。方法以前瞻性研究方法,选择于2018年1月—2021年6月在百色市妇幼保健院妇科门诊体检确诊高危型(HR-HPV)229例女性患者进行宫颈液基细胞学和阴道微生态检查,并随访1年,检测HR-HPV持续感染情况,以同期HPV阴性体检者为对照组,分析HR-HPV持续感染患者阴道微生态及宫颈病变情况和相互关系。结果229例HR-HPV患者,经1年随访,HR-HPV持续和非持续感染组分别为109例和120例,HR-HPV持续感染发生率为47.6%。HR-HPV持续和非持续感染组及HPV阴性组的细菌性阴道发病率分别为20.2%、15.0%和8.6%,外阴阴道假丝酵母菌病分别为19.3%、13.3%和7.9%,滴虫性阴道炎分别为12.8%、9.2%和4.5%,混合性感染分别为10.1%、6.7%和2.7%,H_(2)O_(2)检出率分别为24.8%、18.3%和12.0%,pH值阳性率分别为52.3%、40.8%和36.4%,微生态正常检出率分别为22.9%、32.7%和40.2%,三组各指标差异均有统计学意义(χ^(2)=10.634,10.522,9.010,9.374,10.054,8.268,P<0.01)。HR-HPV持续和非持续感染组不典型鳞状细胞检出率分别为12.8%和10.0%,低度鳞状上皮内病变分别为8.3%和4.2%,高度鳞状上皮内病变分别为4.6%和1.7%,鳞状细胞癌分别为2.8%和0,两组不典型鳞状细胞构成差异无统计学意义(χ^(2)=4.358,P>0.05),低度鳞状上皮内病变、高度鳞状上皮内病变、鳞状细胞癌的构成差异有统计学意义(χ^(2)=11.472、12.685,11.378,P<0.01)。经Spearman秩相关分析,HPV是否感染或感染程度与细菌性阴道病、外阴阴道假丝酵母菌病、滴虫性阴道炎及混合性感染均呈正相关(P<0.05),与H_(2)O_(2)、唾液酸苷酶、白细胞酯酶、pH值阳性率、pH值阳性及四项均为阳性均呈正相关,与微生态正常呈负相关(P<0.01),与低度鳞状上皮内病变、高度鳞状上皮内病变、鳞状细胞癌均呈正相关(P<0.01)
Objective To investigate the correlation between persistent and non-persistent HPV infection and vaginal microecology and cervical lesions,and to provide the basis for HPV prevention and treatment.Methods In this prospective study,229 female patients with high-risk type(HR-HPV)were selected for cervical cytology and vaginal microecological examination in the gynecological outpatient department of Baise Maternal and Child Health Hospital from January 2018 to June2021.The patients were followed up for 1 year to detect persistent HR-HPV infection.The relationship between HR-HPV persistent infection and vaginal microecology and cervical lesions was analyzed using the HPV-negative group as a control.ResultsAmong 229 patients with HR-HPV,there were 109 patients with persistent HR-HPV infection and 120 patients with non-persistent HR-HPV infection in 1-year follow-up,and the incidence of persistent HR-HPV infection was 47.6%.In the HR-HPV persistent and non-persistent infection and HPV-negative groups,the bacterial vaginal incidence was 20.2%,15.0%and 8.6%,respectively;vulvovaginal candidiasis was 19.3%,13.3%and 7.9%,respectively;trichomoniasis vaginitis was 12.8%,9.2%and 4.5%,respectively;mixed infection was 10.1%,6.7%and 2.7%;H_(2)O_(2)detection rate was 24.8%,18.3%and 12.0%,the positive rate of pH value was 52.3%,40.8%and 36.4%,and microecological normal detection rate was 22.9%,32.7%and 40.2%,respectively.There were significant differences among the three groups(χ^(2)=10.634,10.522,9.010,9.374,10.054,8.268,P<0.01).In the HR-HPV persistent and non-persistent infection groups,the rates of atypical squamous cell detection were 12.8%and 10.0%,and 8.3%and 4.2%for low-grade squamous cell lesions,and 4.6%and 1.7%for high-grade squamous cell carcinoma,2.8%and 0 for squamous cell carcinoma,respectively.There was no significant difference in the composition of atypical squamous cells between the two groups(χ^(2)=4.358,P>0.05),there were significant differences in the composition of low-grade,high-grade and squamous cell car
作者
杨颖
韦玉姣
韦桂红
YANG Ying;WEI Yu-jiao;WEI Gui-hong(Department of Gynecology,Baise Maternal and Child Hospital,Baise,Guangxi 533000,China)
出处
《中国热带医学》
CAS
2023年第2期151-156,共6页
China Tropical Medicine
基金
百色市科学研究与技术开发计划课题(No.百科20202523)。
