阴道微生态与高危型H PV感染及宫颈病变的关系

Relationship between vaginal microecosystem and high-risk Human Papillomavirus infection or cervical lesions

目的探讨阴道微生态与高危型人乳头瘤病毒(HPV)感染及宫颈病变的关系。方法选取2016年8月~2018年12月于我院进行宫颈癌筛查的300例女性作为研究对象,均检测阴道微生态、宫颈液基细胞学及高危型HPV,观察并统计乳酸杆菌检出率、清洁度分级、高危型HPV感染及宫颈病变情况。结果研究对象中,乳酸杆菌检测大/中量194例(64.7%),少/无106例(35.3%);阴道清洁度Ⅰ~Ⅱ度252例(84.0%),Ⅲ~Ⅳ度48例(16.0%);高危型HPV感染78例(26.0%),无高危型HPV感染222例(74.0%);宫颈病变64例(21.3%),宫颈正常236例(78.7%);细菌感染(BV)、念珠菌感染、滴虫感染的阳性率分别为10.7%、13.0%、0.6%;宫颈病变者乳酸杆菌少/无、阴道清洁度Ⅲ~Ⅳ度、念珠菌阳性的比例均高于宫颈正常者,差异有统计学意义(P<0.05);宫颈病变与宫颈正常者的BV、滴虫阳性率比较,差异无统计学意义(P>0.05)。结论乳酸杆菌有利于维持阴道微生态平衡,而当女性阴道清洁度差以及合并念珠菌感染时,高危型HPV感染和宫颈病变的风险可能增加。

Objective To investigate the correlation between vaginal microecosystem and high-risk Human Papillomavirus(HPV)infection and cervical lesions.Methods A total of 300 women who were screened for cervical cancer in our hospital from August 2016 to December 2018 were selected as the subjects.All subjects were examined for vaginal microecosystem,cervical liquid-based cytology,and high-risk HPV.The detection of Lactobacillus,cleanliness grading,high-risk HPV infection,and cervical lesions were observed and statistically analyzed.Results In the subjects,194 participants(64.7%)were detected with large/medium amount of Lactobacillus,and 106 cases(35.3%)with less/no Lactobacillus.The vaginal cleanlinessⅠ-Ⅱwas 252 cases(84.0%),and the remaining 48 cases(16.0%)were inⅢ-Ⅳ.A total of 78 cases(26.0%)with high-risk HPV infection,and 222 cases(74.0%)without high-risk HPV infection.There were 64 cases(21.3%)with cervical lesions,and 236 cases(78.7%)with normal cervix.The positive rate of bacterial infection(BV),Monilial infection,and Trichomonas infection were 10.7%,13.0%and 0.6%,respectively.The proportion of Lactobacilli less/no,vaginal cleanlinessⅢ-Ⅳ,and Monilial infection positive in cervical lesions were higher than those in cervical normal cases,the differences were statistically significant(P<0.05).There was no significant difference in BV and Trichomonad positive rates between patients with cervical lesions and those with normal cervix(P>0.05).Conclusion Lactobacillus is beneficial to maintain vaginal micro-ecological balance.Poor cleanliness combined with Monilial infection will increase the risk of high-risk HPV infection and cervical lesions.