高危HPV感染老年患者的阴道菌群分布研究

Distribution of vaginal flora in elderly patients with high-risk HPV infection

目的探究高危型人乳头状瘤病毒(HPV)感染老年患者的阴道菌群分布。方法回顾性分析2015年1月-2017年1月医院收治的98例高危型人乳头状瘤病毒感染老年患者设为病例组,并选取同期医院进行健康检查的98例HPV阴性的老年志愿者为对照组,比较两组患者阴道内环境和阴道内乳酸杆菌种类,分析微生物群落构成。结果两组患者的阴道清洁度、pH值、菌群、阴道炎差异有统计学意义(P<0.05);高危型HPV老年患者阴道清洁度为Ⅲ-Ⅳ度、pH值>4.5、菌群Ⅲ度、有阴道炎的发生率均高于对照组患者;高危型HPV老年患者阴道内微生物群落种类较多,以厚壁菌门和放线菌门为主,对照组阴道内微生物群落86.38%为厚壁菌门(P<0.05);高危型HPV老年患者阴道内惰性乳酸杆菌、卷曲乳酸杆菌和加氏乳酸杆菌少于对照组(P<0.05)。结论阴道清洁度、pH值、菌群、阴道炎与高危型HPV的发生有密切相关性,患者阴道菌群失衡,惰性乳酸杆菌、卷曲乳酸杆菌和加氏乳酸杆菌减少。

OBJECTIVE To explore the distribution of vaginal flora in elderly patients with high-risk human papillomavirus（HPV）infection.METHODS A total of 98 elderly patients with high-risk HPV infection who were treated in the hospital from Jan 2015 to Jan 2017 were assigned as the case group,meanwhile,98 elderly people who received physical examination and were negative for HPV were set as the control group.The endovaginal environment and species of endovaginal Lactobacillus were compared between the two groups of patients,and the constituent ratios of microbial communities were observed.RESULTS There were significant differences in the vaginal cleaness,pH value,flora and vaginitis between the two groups of patients（P〈0.05）.The proportions of the elderly patients with the vaginal cleaness ranging between gradeⅢandⅣ,pH value more than 4.5 and gradeⅢflora were higher in the case group than in the control group,the incidence rate of vaginitis was higher in the case group than in the control group.The thick-walled bacteria and actinomycetes were dominant among the endovaginal microbial communities in the elderly patients positive for high-risk HPV,while,86.38% of the endovaginal microbial communities were the thick-walled bacteria in the control group（P〈0.05）.The constituent ratios of the endovaginal inert Lactobacillus,Lactobacillus crispatus and Lactobacillus galleri of the case group were significantly lower than those of the control group（P〈0.05）.CONCLUSION The incidence of high-risk HPV is closely associated with the vaginal cleaness,pH value,flora and vaginitis.The vaginal flora of the patients are out of balance,and the constituent ratios of inert Lactobacillus,L.crispatus and L.galleri are reduced.