人乳头瘤病毒(HPV)感染与阴道微生态的相关性研究

Relationship between human papillomavirus infection and vaginal microecology

目的探讨人乳头瘤病毒(HPV)与阴道微生态的相关性。为阴道微生态失衡患者及时纠正阴道菌群的紊乱,避免或减少其感染HPV及宫颈癌的防治提供科学依据。方法选取2015年5月-2016年6月在我院妇科门诊就诊的1 412例患者进行HPV、阴道微生态检测。分析阴道菌群及微生态结果与HPV感染的相关性。结果 1 412例患者中HPV阳性有542例,占38.39%,HPV阴性有870例,占61.61%。分别以革兰阳性大杆菌、革兰阴性短杆菌、革兰阳性杆菌、革兰阳性球菌/链球菌为优势菌及无优势菌的患者,HPV感染率分别为34.45%、49.16%、33.33%、39.28%、38.70%,OR值分别为0.654(0.526~0.815)、1.818(1.426~2.318)、1.426(0.515~1.209)、1.039(0.483~2.236)、1.014(0.601~1.711)。细菌性阴道病(BV)、滴虫性阴道炎(TV)、需氧性阴道炎(AV)、外阴阴道假丝酵母菌病(VVC)的HPV感染阳性率分别为27.49%、1.29%、7.38%、12.54%,P值分别为0.000、0.754、0.570、0.318。结论 HPV感染与革兰阴性短杆菌及BV显著相关,革兰阳性大杆菌与HPV的感染呈负相关,菌群紊乱及BV可能增加HPV感染的风险。

Objective To explore the relationship between human papillomavirus（HPV）and vaginal microecology,and provide scientific basis for the control of the disease and prevention of cervical cancer.Methods 1,412 patients in the gynecological department of our hospital from May 2015 to June 2016 were included and underwent HPV detection and vaginal microecological testing.The results were analyzed in regards to the relationship between vaginal microflora and HPV infection.Results Among the 1,412 patients,542 were HPV-positive（38.39%）,and 870 were HPV-negative（61.61%）.The HPV infection rate in patients with G＋b（L）,G-b（S）,G＋b or G＋c/s as the predominant bacteria were 34.45%,49.16%,33.33%and 39.28% respectively[ORvalues were 0.654（0.526-0.815）,1.818（1.426-2.318）,1.426（0.515-1.209）and 1.039（0.483-2.236）respectively],while that in patients without predominant bacteria was38.70% [OR=1.014（0.601-1.711）].The positive rates of HPV infection in bacterial vaginosis（BV）,trichomonas vaginitis（TV）,aerobic vaginitis（AV）and vulvovaginal candidiasis（VVC）were 27.49%（P=0.000）,1.29%（P=0.754）,7.38%（P=0.570）and 12.54%（P=0.318）respectively.Conclusion HPV infection was significantly associated with G-b（S）and BV;G＋b（L）was negatively correlated with HPV infection;dysbacteriosis and BV may increase the risk of HPV infection.