宫颈高危型人乳头瘤病毒感染与阴道微生态及局部细胞免疫的关系

Relationship between cervical high risk human papillomavirus infection and vaginal microecology and local cellular immunity

目的探究宫颈高危型人乳头瘤病毒(HPV)感染与阴道微生态及局部细胞免疫的关系。方法选取2017年2月~2019年6月昆明市妇幼保健院因宫颈炎就诊的女性患者218例为研究对象。所有患者均行高危型HPV检查,根据结果将其分为观察组(n=80,高危型HPV阳性者)、对照组(n=138,高危型HPV阴性者)。比较两组阴道微生态失调的情况及宫颈局部细胞免疫情况,Pearson相关性分析分析宫颈高危型HPV感染与阴道微生态及局部细胞免疫的关系。结果共检测出高危型HPV感染患者80例,阳性率为36.70%(80/218),其中以HPV16的检出率最高(52.50%),其次是HPV52(22.50%)。观察组阴道微生态失调、支原体、解脲脲原体、衣原体、乳酸杆菌异常率、细菌性阴道炎发生率均高于对照组(均P <0.05)。观察组CD4^+、CD4^+/CD8^+均低于对照组(P <0.05)。高危型HPV感染与宫颈局部CD4^+、CD4^+/CD8^+呈负相关(r=-0.453、-0.421,P <0.05),与细菌性阴道炎、衣原体、乳酸杆菌、解脲脲原体呈正相关(r=0.432、0.525、0.504、0.472,P <0.05)。结论宫颈高危型HPV感染与阴道微生态及局部细胞免疫息息相关,可加重患者的阴道微生态紊乱,降低患者局部细胞免疫功能。

Objective To investigate the relationship between high risk human papillomavirus(HPV)infection and vaginal microecology and local cellular immunity.Methods From February 2017 to June 2019,218 female patients with cervicitis who came to Kunming Maternal and Child Health Hospital were selected as the study subjects.All patients were tested for high risk HPV examination,according to the results,they were divided into observation group(n=80,high risk HPV positive),control group(n=138,high risk HPV negative).The vaginal microecology disorders and cervical local cell immunity were compared between two groups.Pearson correlation analysis was used to analyze the relationship between cervical high risk HPV infection and vaginal microecology and cervical local cellular immunity.Results Eighty cases were found to be high risk HPV infection,the positive rate was 36.70%(80/218),among which HPV16 was the highest(52.50%),followed by HPV52(22.50%).The vaginal microecology disorder,mycoplasma,ureaplasma urealyticum,chlamydia,lactobacillus abnormal rate and bacterial vaginitis rate in observation group were higher than those in control group(P<0.05).CD4^+,CD4^+/CD8^+in observation group were lower than those in control group(P<0.05).High risk HPV infection was negatively correlated with CD4^+,CD4^+/CD8^+(r=-0.453,-0.421,P<0.05),while positively correlated with bacterial vaginitis,chlamydia,lactobacillus and ureaplasma urealyticum(r=0.432,0.525,0.504,0.472,P<0.05).Conclusion Cervical high risk HPV infection is closely related to vaginal microecology and cervical local cellular immunity,which can aggravate the disorder of vaginal microecology and reduce the local cellular immune function of patients.