门诊阴道镜检查患者阴道菌群构成与HPV16感染的关系

Relationship between human papillomavirus 16 infection and vaginal microflora composition in outpatients based on colposcopy

目的探讨门诊阴道镜检查患者阴道菌群构成与HPV16感染的关系。方法选取我院2016年3月-2018年12月门诊阴道镜检查的高危HPV感染患者96例为研究对象,通过阴道镜检查结果分析其HPV16感染情况、阴道菌群构成及菌群多样性。结果 HPV16阳性组人数41例,阴性组55例,感染率为42.7%。HPV16阳性组患者阴道菌群中占前5位的是乳酸杆菌属、加德纳菌属、嗜胨菌属、纤毛菌属及普氏菌属,阴性组占前5位的分别为乳酸杆菌属、加德纳菌属、奇异菌属、嗜胨菌属及卟啉单胞菌属。HPV16阳性组乳酸杆菌属构成比显著小于HPV阴性组,差异具有统计学意义(P=0.007,χ^(2)=7.195),两组加德纳菌属、嗜胨菌属构成比无差异(P=0.073,χ^(2)=3.217;P=0.763,χ^(2)=0.091)。HPV16阳性组菌群Shannon指数、ACE指数、Chaol指数显著大于阴性组,差异具有统计学意义(P=0.014,χ^(2)=2.461;P=0.002,χ^(2)=3.025;P<0.001,χ^(2)=4.534);Simpson指数比较差异无统计学意义(P=0.310,χ^(2)=0.406)。结论阴道菌群结构的改变主要表现为乳酸杆菌属数量的减少及加德纳菌属、嗜胨菌属、普氏菌属及纤毛菌属的增加,这可能与HPV16感染有一定关系。

Objective To explore the relationship between human papillomavirus 16(HPV16) infection and vaginal microflora composition in outpatients based on colposcopy. Methods Ninety-six patients with high risk HPV infection, who underwent colposcopy in our hospital from March 2016 to December 2018 were enrolled. HPV16 infection, vaginal flora composition and community diversity were analyzed with the colposcopy. Results Forty-one cases were positive for HPV16, 55 cases were negative for HPV16;the HPV16 infection rate was 42.7%. In the HPV16 positive group, Lactobacillus, Gardnerella, Peptonophilus, Leptothrix and Prevotella were the top five vaginal bacteria, while Lactobacillus, Gardnerella, Strangobacter, Peptonophilus and Porphyrin were the top five vaginal bacteria in the HPV16 negative group. The composition ratio of Lactobacillus in the HPV16 positive group was significantly lower than that in the HPV negative group(P=0.007, χ^(2)=7.195). The composition ratio of Gardnerella and Peptonophilus showed no difference between groups(P=0.073, χ^(2)=3.217;P=0.763, χ^(2)=0.091). The Shannon index, ACE index and Chaol index in HPV16 positive group were significantly higher than those in HPV16 negative group(P=0.014, χ^(2)=2.461;P=0.002, χ^(2)=3.025;P<0.001, χ^(2)=4.534);there was no significant difference in Simpson index between groups(P=0.310, χ^(2)=0.406). Conclusion The change of vaginal flora structure mainly manifests as the decrease of Lactobacillus and the increase of Gardnerella, Peptonophilus, Prevotella and Leptothrix, which might be related to HPV16 infection to some extent.