阴道微环境对LSIL进展的影响

Effect of vaginal microenvironment on the progression of LSIL

目的旨在通过对山西省564例确诊的宫颈上皮内瘤变(LSIL)妇女基线及随访的阴道微环境相关数据的整理,分析阴道微环境对LSIL进展的影响。方法采用前瞻性队列研究方法分析山西省阳曲、介休两地489例LSIL患者人口学特征和阴道微环境对LSIL结局的影响,其中LSIL消退者400例设为对照组,未消退组89例设为观察组。结果队列患者年龄为(51. 00±9. 18)岁,46~55岁之间的人数最多(43. 0%),43. 1%的患者家庭年收入在1万~3万元之间。患者本人吸烟率为1. 8%,而有306例(62. 6%)患者被动吸烟。大部分LSIL患者的怀孕次数都在3次左右,71. 6%女性的阴道p H值不正常(p H>4. 5),28. 4%女性p H正常(p H≤4. 5)。患有阴道炎的女性占比56. 6%。年龄、接受教育年限、家庭收入、是否吸烟、是否被动吸烟、怀孕次数、流产次数以及是否患有阴道炎对LSIL是否进展无影响(P>0. 05);产次和阴道p H对LSIL在2年内能否消退有一定提示作用(P<0. 05)。结论在宫颈癌防治工作中,对产次较多、阴道p H值异常的LSIL患者提高随访率,可以及早发现病情的进展,从而对患者进行及时的治疗,保证女性健康。

Objective To summarize the baseline and follow-up vaginal microenvironment-related data of 564 women diagnosed as LSIL in Shanxi,analyze the effect of vaginal microenvironment on the progression of LSIL. Methods A prospective cohort study was conducted to analyze the demographic characteristics of 489 patients with LSIL and the effect of vaginal microenvironment on LSIL outcomes in Yangqu and Jiexiu,Shanxi. Among them,400 patients with LSIL remission were enrolled into control group,and 89 patients without LSIL remission were enrolled into experimental group. Results The age of the cohort was( 51. 00±9. 18) years old,the highest number was between 46-55 years old( 43. 0%),and 43. 1% of the patients had an annual income of 10 000-30 000 RMB. The smoking rate of the patients was 1. 8%,while 306 patients( 62. 6%) suffered from passive smoking. Most LSIL patients have a pregnancy count of about 3 times,71. 6% of the women had abnormal vaginal p H value( p H>4. 5),and 28. 4% of the women had normal p H value( p H≤4. 5). The proportion of women with vaginitis was 56. 6%. Age,education years,family income,smoking,passive smoking,times of pregnancy and abortion,combining with vaginitis or not had no impact on progression of LSIL( P> 0. 05). Parity and vaginal p H had a certain reference effect on LSIL remission within 2 years( P<0. 05). Conclusion In prevention and treatment of cervical cancer,for LSIL patients with many parity and abnormal vaginal p H value,follow-up rate should be improved to early detect the progression of LSIL,treat the patients,and ensure female health.