LEEP联合膦甲酸钠对人乳头瘤病毒的转阴率及再感染率的影响

Effect of LEEP combined with foscarnet on negative conversion rate and reinfection rate of human papillomavirus

目的研究高频电波刀宫颈电圈切除术(LEEP)联合膦甲酸钠治疗宫颈上皮内瘤变(CIN)合并人乳头瘤病毒(HPV)感染患者的效果及对转阴率、再感染率的影响。方法采用回顾性分析方法,研究对象为2017年1月至2019年12月内蒙古医科大学附属医院入院的200例CIN合并HPV感染患者,根据不同治疗方式分为对照组和研究组,各100例。对照组单用LEEP治疗,研究组选用LEEP联合膦甲酸钠治疗。比较2组患者治疗前后宫颈炎评分,治疗后3个月、6个月HPV转阴率、HPV再感染率、宫颈薄层液基细胞学检查(TCT)未见上皮内瘤样病变率。结果研究组治疗前后宫颈炎评分分别为(3.16±0.54)分、(1.39±0.55)分,对照组治疗前后宫颈炎评分分别为(3.19±0.58)分、(1.98±0.47)分;2组治疗前宫颈炎评分比较差异无统计学意义(P>0.05);2组治疗后较治疗前宫颈炎评分更低,且研究组治疗后低于对照组(P<0.05)。研究组治疗后3个月、6个月HPV转阴率分别为90.00%、95.00%,HPV再感染率分别为6.00%、2.00%,TCT未见上皮内瘤样病变及恶性细胞率分别为91.00%、93.00%;对照组治疗后3个月、6个月HPV转阴率分别为71.00%、76.00%,HPV再感染率分别为20.00%、13.00%,TCT未见上皮内瘤样病变及恶性细胞率分别为70.00%、75.00%。研究组较对照组治疗后3个月、6个月HPV转阴率、HPV再感染率更低,TCT未见上皮内瘤样病变及恶性细胞率更高(P<0.05)。结论LEEP联合膦甲酸钠治疗CIN合并HPV感染患者的效果明显优于单一LEEP治疗,可提升HPV转阴率,减少HPV再感染风险。

Objective To observed the Loop electrosurgical excision procedure(LEEP)joint Cervical intraepithelial neoplasia(CIN)merge Human papilloma virus(HPV)effect of infected patients and its influence on the rate of negative conversion and reinfection.Methods A retrospective analysis was conducted on 200 CIN I patients with HPV infection who were admitted from January 2017 to December 2019.The subjects were divided into two groups according to different treatment methods:one group was the control group and the other was the study group,with 100 cases each.The control group was treated with LEEP alone,while the study group was treated with LEEP combined with foscarnet.Comparison of cervicitis scores before and after treatment with HPV negative conversion rate,HPV re-infection rate,and no intraepithelial neoplasia rate on Thinprep Cytologic test(TCT)was made between the two groups.Results Cervicitis scores before and after treatment were(3.16±0.54)and(1.39±0.55)in the study group,and(3.19±0.58)and(1.98±0.47)in the control group.There were no significant differences in cervicitis scores between the two groups before treatment(P>0.05).Cervicitis scores after treatment were lower in the two groups than before treatment,and the research group were lower than the control group(P<0.05).In the study group,the conversion rate of HPV to negative at 3 months and 6 months after treatment was 90.00% and 95.00%,and the HPV reinfection rate was 6.00% and 2.00%,respectively.TCT showed no intraepithelial neoplasia lesions and the rate of malignant cells was 91.00% and 93.00%,respectively.In the control group,the conversion rate of HPV to negative 3 months and 6 months after treatment was 71.00%and 76.00%,and the HPV reinfection rate was 20.00% and 13.00%,respectively.TCT showed no intraepithelial neoplasia lesions and malignant cells was 70.00% and 75.00%,respectively.The HPV negative conversion rate and HPV reinfection rate in the study group were lower than those in the control group at 3 and 6 months after treatment.TCT showed no intraepithelial neoplasia and higher malignant cell rate(P<0.05).Conclusion The efficacy of LEEP combined with foscarnet sodium in the treatment of CIN I patients with HPV infection is significantly better than that of LEEP alone,which can improve the negative conversion rate of HPV and reduce the risk of HPV reinfection.