宫颈上皮内瘤变与生殖道感染的关系

Relationship between cervical intraepithelial neoplasia and genital tract infection

目的探讨宫颈上皮内瘤变(CIN)与生殖道滴虫、细菌性阴道病、沙眼衣原体、解脲脲原体、人乳头瘤病毒(HPV)感染的关系。方法选择医院妇科2014年1月-2015年12月宫颈CIN患者300例为CIN组,宫颈上皮正常者300例为对照组,检测生殖道滴虫、细菌性阴道病、沙眼衣原体、解脲脲原体、HPV感染情况。结果 CIN组滴虫、细菌性阴道病、沙眼衣原体、解脲脲原体、HPV16/18感染率(25.3%、29.3%、29.0%、53.0%、75.0%)均高于对照组(13.0%、14.7%、7.3%、43.7%、4.0%)(P<0.05);CINⅠ亚组、CINⅡ亚组、CINⅢ亚组之间生殖道滴虫、细菌性阴道病、沙眼衣原体、解脲脲原体感染率比较差异无统计学意义,CINⅡ亚组、CINⅢ亚组HPV16/18感染率(83.5%、92.4%)均明显高于CINⅠ亚组(55.9%),但CINⅡ亚组和CINⅢ亚组HPV16/18感染率比较差异无统计学意义;CIN组HPV16/18感染合并滴虫感染、HPV16/18感染合并细菌性阴道病、HPV16/18感染合并沙眼衣原体、HPV16/18感染合并解脲脲原体的发生率(6.7%、11.7%、18.0%、40.3%)均高于对照组(0.3%、0.3%、1.0%、1.7%)(P<0.05);生殖道HPV16/18感染与滴虫、细菌性阴道病、沙眼衣原体感染呈正相关(r=0.013、0.020、0.027,P<0.05),和解脲脲原体感染无显著相关性。结论宫颈CIN与生殖道滴虫、细菌性阴道病、沙眼衣原体、解脲脲原体、HPV16/18感染有关,HPV16/18感染与病情进展有关,与生殖道滴虫、细菌性阴道病、沙眼衣原体感染呈正相关。

OBJECTIVE To explore the relationship between the cervical intraepithelial neoplasia （CIN） and the genital trichomoniasis,bacterial vaginosis,Chlamydia trachomatis infection,Ureaplasma urealyticum infection,and human papillomavirus （HPV） infection.METHODS Totally 300 patients with CIN who were treated in gynecology department from Jan 2014 to Dec 2015 were chosen as the CIN group,and 300 people with normal cervical epithelium were set as the control group.The prevalence rates of genital trichomoniasis,bacterial vaginosis,C.trachomatis infection,U.urea@ticum infection,and HPV infection were determined.RESULTS The incidence rates of genital trichomoniasis,bacterial vaginosis,C.trachomatis infection,U.urealyticum infection,and HPV infection of the CIN group were respectively 25.3%,29.3%,29.0%,53.0%,and 75.0%,significantly higher than 13.0%,14.7%,7.3%,43.7%,and 4.0% of the control group （P〈0.05）.There was no significant difference in the incidence rate of genital trichomoniasis,bacterial vaginosis,C.trachomatis infection,or U.urealyticum infection among the CIN group Ⅰ,the CIN group Ⅱ,and the CIN group Ⅲ;the incidence rate of HPV16/18 infection was 83.5% in the CIN group Ⅱ,92.4% in the CIN group Ⅲ,significantly higher than 55.9% in theCIN group Ⅰ,however,there was no significant difference in the incidence rate of HPV166/18 infection between the CIN group Ⅱ and the CIN group Ⅲ.The incidence rates of HPV16/18 infection complicated with trichomoniasis,HPV16/18 infection complicated with bacterial vaginosis,HPV16/18 infection complicated with C.trachomatis infection,and HPV16/18 infection complicated with U.urealyticum infection of the CIN group were respectively 6.7%,11.7%,18.0%,and 40.3%,significantly higher than 0.3%,0.3%,1.0%,and 1.7% of the control group （P〈0.05）.The genital tract HPV16/18 infection was positively correlated withtrich omoniasis,bacterial vaginosis,and C.trachomatis infection （r=0.013,0.020,0.027,P〈0.05）but was not significantly associated with the U.urealyticum infection.CONCLUSION The CIN is associated with the genital trichomoniasis,bacterial vaginosis,C.trachomatis infection,U.urealyticum infection,and HPV16/18 infection;the HPV16/18 infection is associated with the progression of illness condition and is positively correlated with the genital trichomoniasis,bacterial vaginosis,and C.trachomatis infection.