高危型人乳头状瘤病毒、人巨细胞病毒、人疱疹病毒4型、解脲脲原体感染与宫颈病变的关系

Relationship between infections of high-risk HPV,CMV,EBV,UU in women and cervical lesions

目的探讨高危型人乳头状瘤病毒(HR-HPV)合并人巨细胞病毒(CMV)、人疱疹病毒4型(EBV)、解脲脲原体(UU)感染在宫颈上皮内瘤变中的作用,并分析年龄与宫颈上皮内瘤变的相关性。方法选取2015年1-12月该院收治的宫颈高级别病变(HSIL)患者46例、低级别病变(LSIL)患者42例、未明确意义的非典型鳞状上皮细胞不排除病变(ASCUS)患者41例和正常对照(NILM)患者107例为研究对象。通过流式荧光杂交和实时荧光定量基因扩增法分别检测HR-HPV、CMV、EBV、UU感染情况。并通过SPSS 17.0软件运用χ~2检验和多项Logistic回归分析其感染状态与宫颈病变的相关性。结果UU感染率在各组中均为最高,其次是CMV,EBV感染率最低。UU、CMV感染及年龄在各病变组间差异有统计学意义(P<0.01);两种及以上微生物合并HR-HPV感染在各组间差异有统计学意义(P<0.01)。结论 CMV、EBV、UU合并HR-HPV感染分别与宫颈上皮内瘤变呈正相关,随年龄增大,病变风险增大。且UU更容易合并HR-HPV感染。HR-HPV及微生物联合检测在宫颈癌的预防治疗中具有重要作用。

Objective To explore the roles of high-risk human papillomavirus（HR-HPV） combined with Cytomegalovirus（CMV）,Epstein-Barr virus（EBV）,Ureaplasma urealyticum（UU） infections in patients with cervical intraepithelial neoplasia,analyze the relationship between age and cervical intraepithelial neoplasia.Methods A total of 46 patients withs HSIL,42 patients with LSIL,41 patients with ASCUS,and 107 normal women（NILM） were selected from the hospital from Janaury to December in 2015.The presence of HPV infection and identification of CMV,EBV,UU were confirmed by real-time quantitative PCR.The results were analyzed by chi-square test and multivariate logistic regression.Results The infection rate of UU was the highest in different groups,followed by CMV,the infection rate of EBV was the lowest.There was statistically significant difference in the infection rate of UU and CMV among different age groups（P〈0.01）;there was statistically significant difference in the infection rate of HR-HPV combined with two or more than two kinds of microorganism infection among different groups（P〈0.01）.Conclusion CMV,EBV,UU combined with HR-HPV infections are respectively positively correlated with cervical intraepithelial neoplasia.The risk of CIN increases with the increase of age.The presence of UU is significantly associated with HR-HPV infection,joint detection of microorganism and HR-HPV plays a important role in the prevention and treatment of cervical cancer.