高危型人乳头瘤病毒感染者宫颈病变程度与阴道内环境的关系

Relationship between Severity of Cervical Lesions and Vaginal Environment in Patients with High-Risk HPV Infection

目的探讨高危型人乳头瘤病毒(HPV)感染者宫颈病变严重程度与阴道内环境的关系。方法选取425例高危型HPV感染患者,均行宫颈液基薄层细胞学检查(TCT)以了解宫颈病变程度,并行阴道内环境监测,对比不同程度宫颈病变者阴道内环境指标的差异。结果 TCT检查:正常13例,炎症132例,CINⅠ级111例,CINⅡ级90例,CINⅢ级54例,宫颈癌25例。阴道内环境检测:阴道清洁度≤Ⅱ级者194例,pH值≤4.5者202例,菌群分布≤Ⅰ级者244例,滴虫感染者56例,假丝酵母菌感染者48例,阴道炎患者240例。不同程度宫颈病变阴道内环境指标对比:阴道清洁度≥Ⅲ级、pH值≤4.5、菌群分布≥Ⅱ级、阴道炎的发生率在不同TCT检查结果的患者中差异有统计学意义(均P<0.05),而滴虫感染及假丝酵母菌感染发生率在不同TCT检查结果的患者中较差异无统计学意义(P>0.05)。结论阴道内环境的改变与HPV感染存在密切关系,阴道内环境动态平衡的破坏可能对HPV感染者宫颈病变的进一步发展起到了一定促进作用,但两者的确切关系有待进一步研究。

ABSTRACT:Objective To investigate the relationship between the severity of cervical lesions and vaginal environment in patients with high-risk human papillomavirus(HPV)infection.Meth-ods The severity of cervical lesions was detected by thin-layer cytological test(TCT)and vaginal environment was monitored in 425 patients with HPV infection.The indicators of vaginal environ-ment were compared among patients with different degrees of cervical lesions.Results Among the 425 patients,TCT showed normal in 13,inflammation in 132,CIN Ⅰ in 111,CIN Ⅱ in 90, CIN Ⅲ in 54,and cervical cancer in 25.Vaginal environment monitoring showed vaginal cleanli-ness≤Ⅱ in 194,pH≤4.5 in 202,bacterial flora distribution≤Ⅰ in 244,Trichomonas infection in 56,Candida infection in 48,and vaginitis in 240.There were significant differences in the inci-dences of vaginal cleanliness≥Ⅲ,pH≤4.5,bacterial flora distribution≥Ⅱ and vaginitis among patients with different degrees of cervical lesions(P <0.05).No significant differences in the inci-dences of Trichomoniasis or Candida infection among patients with different degrees of cervical le-sions(P >0.05).Conclusion There is a close relationship between changes in vaginal environ-ment and HPV infection.The disorder of dynamic balance of vaginal environment may promote&nbsp;the further development of cervical lesions in patients with HPV infection.However,the exact re-lationship between vaginal environment and HPV infection needs to be further studied.