高危型人乳头瘤病毒感染与阴道微生态的相关性

Relationship between high-risk human papillomavirus infection and vaginal microecology

目的:探讨高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)感染与阴道微生态的相关性。方法:选取HR-HPV阳性受试者296例、HR-HPV阴性受试者316例作为研究对象,分析两组的阴道菌群、微生态相关指标、微生态失调及细菌性阴道病(bacterial vaginitis,BV)的发生情况。结果:与HR-HPV阴性组比较,HR-HPV阳性组菌群密集度(II～III)、菌群多样性(II～III)比率显著降低(χ~2分别为18.548,16.693,均P<0.01),两组受试者优势菌比例差异无统计学意义(χ~2=0.217,P>0.05)。与HR-HPV阴性组比较,HR-HPV阳性组过氧化氢、白细胞酯酶和唾液酸苷酶的阳性率均明显升高(χ~2分别为10.560,8.030,12.969,均P<0.01),两组pH值>4.5的比率差异无统计学意义(χ~2=0.079,P>0.05)。与HR-HPV阴性组相比,HR-HPV阳性组微生态失调及BV的比率均明显升高(χ~2分别为14.882,9.141,均P<0.01)。结论:HR-HPV感染与阴道微生态失调及BV密切相关,维护阴道微生态平衡,可有效降低HR-HPV的感染,也是预防宫颈病变的有效途径。

Objective: To investigate the relationship between high-risk human papillomavirus (HR-HPV) infection and vaginal microecology. Methods: A total of 296 HR-HPV-positive subjects and 316 HR-HPV-negative subjects were selected. The vaginal flora, vaginal microecological indicators, microecological disorders and bacterial vaginosis were compared between the two groups. Results: Compared with the HR-HPV-negative group, the HR-HPV-positive group showed a significant decrease in the bacterial density (Ⅱ-Ⅲ) and microbial diversity (Ⅱ-Ⅲ)(χ^2 were 18.548 and 16.693 respectively;all P<0.01). There was no statistical difference in the proportion of dominant bacteria between the two groups (χ^2 =0.217, P>0.05). Compared with the HR-HPV negative group, the positive rates of hydrogen peroxide, leukocyte esterase and sialidase were significantly increased in the HR-HPV positive group (χ^2 were 10.560, 8.030 and 12.969 respectively;all P<0.01). There was no statistically significant difference in pH value between the two groups (χ^2 =0.079, P>0.05). Compared with the HR-HPV-negative group,the ratios of microecological disorders and bacterial vaginosis were significantly increased in the HR-HPV-positive group (χ^2 were 14.882 and 9.141 respectively;all P<0.01). Conclusion: HR-HPV infection is closely related to vaginal microecological disorders and bacterial vaginosis, maintaining vaginal microecological balance is an effective way to reduce HR-HPV infection and prevent cervical lesions.