长期放置宫内避孕器后宫颈病变发生率的研究

Incidence of cervix diseases in long-term intrauterine devices users

目的:研究长期放置宫内避孕器(IUD)后子宫颈病变的发生率及安全性。方法:选择放置5￣14年惰性和含铜IUD者,采集宫颈脱落细胞学液基标本,采用伯塞斯达系统(TBS)诊断标准行宫颈细胞病理学诊断,采用荧光定量聚合酶链反应(FQ-PCR)技术检测同一液基标本中乳头状瘤病毒(HPV)、单纯疱疹病毒Ⅱ(HSVⅡ)、巨细胞病毒(HCMV)及沙眼衣原体(CT)的DNA含量。结果:①细胞学诊断结果:惰性IUD组有2例、含铜IUD组有4例诊断为未明确诊断意义的不典型鳞状细胞(ASCUS),均于3￣6月后复查时转为正常。其余病例均在正常范围;②DNA定量测定结果:HPV-6/11、HSVⅡ、HCMV、CT4种病原体的阳性表达率及平均DNA含量在惰性IUD组、含铜IUD组及对照组中两两相比差异均无统计学意义(P>0.05)。3组HPV16/18型均为阴性。结论:长期放置IUD不增加宫颈HPV、HSVⅡ、HCMV、CT感染率,不增加宫颈上皮内瘤变(CIN)发生率。

Objective： To study the relationship between long-term using of intrauterine device （IUD） and CIN. Methods： Sixty-four patients wearing IUD and 60 wearing copper-releasing tailed IUD for 5- 14 years were selected as the study group, 54 normal persons as the control group. Fluorescence quantitative-PCR （FQ-PCR） technique was used to detect the fixed quantity of HPV, HSV lI, HCMV and CT DNA. Results： Two patients in IUD group and 4 in copper-releasing IUD group were diagnosed as ASCUS, but turned to normal after 3-6 months. There was no significant difference of the positive rate and the fixed quantity of HPV 6/11,HSV 11, HCMV, CT DNA between the three groups. HPV16/18 of all samples was negative. Conclusion： The risk of CIN does not increase in IUD long-term users.