阴道微生态和高危型HPV感染与宫颈病变的相关性

Correlation between vaginal microecology,high-risk human papillomavirus infection and cervical lesions

目的分析阴道微生态和高危型人乳头瘤病毒(HPV)感染与宫颈病变的相关性,为宫颈病变治疗寻找新的靶点。方法选取2014年2月-2016年2月医院收治的宫颈病变患者108例为研究对象,并设为试验组,选取同期医院健康体检的健康志愿者100例为对照组,对研究对象实施阴道微生态平衡状况检查、阴道微菌群检查、高危HPV感染筛查。比较两组受试者阴道微生态失调率、阴道菌群检出情况、HPV阳性率、HPV分型构成情况;并分析阴道微生态失调、HPV阳性、宫颈病变间的相关性。结果试验组阴道微生态失调率为60.19%(65/108)、HPV阳性率为82.41%(89/108)高于对照组(P<0.05)。试验组患者阴道乳酸杆菌、线索细胞、阴道滴虫检出率为53.70%(58/108)、38.89%(42/108)、34.26%(37/108)高于对照组(P<0.05),其他菌群比较差异无统计学意义。试验组患者HPV-16、HPV-18检出率分别为45.37%(49/108)、26.85%(29/108)高于对照组(P<0.05)。阴道微生态失调、HPV阳性与宫颈疾病呈正相关。结论宫颈病变与阴道微生态失调和HPV感染高度相关,关注宫颈病变患者阴道微生态状况及HPV感染情况,对临床治疗方案的选择具有一定的指导价值。

OBJECTIVE To analyze the correlation between vaginal microecology,highrisk human papillomavirus（HPV）infection and cervical lesions so as to seek for new target for treatment of cervical lesions.METHODS A total of 108 patients with cervical lesions who were treated in the hospital from Feb 2014 to Feb 2016 were enrolled in the study and assigned as the experimental group,meanwhile,100 healthy people who received physical examination were chosen as the control group.The vaginal microecological balance status examination,vaginal micro flora examination and screening of highrisk HPV infection were carried out for the study objects.The vaginal microecological imbalance rate,isolation rates of vaginal flora,positive rate of HPV and subspecies of HPV were observed and compared between the two groups of participants.The correlation between the vaginal microecological imbalance,positive HPV and cervical lesions was observed.RESULTS The rate of vaginal microecological imbalance and positive rate of HPV of the experimental group were respectively 60.19%（65/108）and 82.41%（89/108）,significantly higher than those of the control group（P〈0.05）.The isolation rates of vaginal lactobacillus,clue cells and Candida were respectively 53.70%（58/108）,38.89%（42/108）and 34.26%（37/108）in the experimental group,significantly higher than those in the control group（P〈0.05）,there were no significant differences in the isolation rates of other flora between the two groups.The isolation rates of HPV16 and HPV18 of the experimental group were respectively 45.37%（49/108）and 26.85%（29/108）,significantly higher than those of the control group（P〈0.05）.The vaginal microecological imbalance and positive HPV were positively correlated with the cervical lesions.CONCLUSIONThe cervical lesions are highly correlated with the vaginal microecological imbalance and HPV infection.It is necessary to focus on the vaginal microecological status and HPV infection of the patients with cervical lesions so as provide guidance for the clinical treatment.