HR-HPV合并UU感染状况及与宫颈上皮内瘤变的相关性研究

Study on the relationship between high-risk humanpapilloma virus with ureaplasma urealyticum infection and cervical intraepithelial neoplasia

目的通过检测高危型人乳头瘤病毒HR-HPV和UU的感染情况,分析探讨HR-HPV合并UU感染与宫颈上皮内瘤变发生的相关性。方法选择2014年8月至2017年6月间门诊就诊的女性患者和健康体检者宫颈分泌物样本1 159例,采用流式荧光杂交技术进行17种HPV高危亚型检测,同时采用实时荧光定量PCR技术检测UU-DNA载量,并随机选择122例受检者样本进行薄层液基细胞学检查,结果经统计学卡方分析。结果 1 159例样本中HR-HPV阳性总感染率为20.97%(243/1 159),UU总阳性感染率为67.56%(783/1 159);在783例UU阳性患者中,HR-HPV检测阳性188例(24.01%,188/783),而在UU检测阴性的376例患者中,HR-HPV阳性55例(14.63%,55/376),2组相比差异具统计学意义(X^2=13.50,P=0.000 2)。其中在HR-HPV合并UU感染的患者中,高致病性HPV16亚型合并感染率最高,为93.33%。随机选择的122例样本行薄层液基细胞学检查结果中,UU阳性组中的CIN发生率明显高于UU阴性组,且在HR-HPV合并UU感染患者中,CIN的发生率较单纯感染及阴性对照组显著升高。结论 UU感染可增加HR-HPV感染的风险,且HR-HPV合并UU阳性感染更易导致患者CIN的发生。

Objective To detect the infection status of high-risk human papilloma virus（HR-HPV）and ureaplasma urealyticum（UU）, and to analyze the relationship between HR-HPV/UU co-infection and cervical intraepithelial neoplasia（CIN）. Methods A total of 1 159 samples of cervical secretionsfrom female patients and healthy volunteers were collected in Dongguan Tung Wah hospital from August 2014 to June 2017. 17 high-risk subtypes of HPV were detected by flow-fluorescence hybridization,the virus load of UU-DNA were detected by real-time PCR simultaneously. 122 samples were randomly selected for liquidbased cytologic test（LCT）. The results are analyzed by Chi-square analysis. Results The total infection rate of HR-HPV in 1 159 samples was 20.97%（243/1 159）,and that of UU was 67.56%（783/1 159）.Among 783 UU positive samples,the HR-HPV positive rate was 24.01 %（188/783）,while the HR-HPV positive rate was 14.63%（55/376）in 376 UU negative samples,the difference between the 2 groups was statistically significant（X^2=13.50,P=0.000 2）. Among the patients with HR-HPV combined with UU infection,the highest prevalence of highly pathogenic HPV16 subtypes was 93.33%. Among 122 random samples selected for thin-layer liquid-based cytology（LCT）,the incidence of CIN in the UU-positive group was significantly higher than that in the UU-negative group,and the incidence of CIN in patients with HRHPV and UU infection was higher than that of simple infection and the negative control group. Conclusion UU infection can increase the risk of HR-HPV infection,and HR-HPV combined with UU-positive infection is more likely to lead to the occurrence of CIN in patients.