阴道菌群紊乱对老年宫颈上皮内瘤变进展的影响

Effect of Vaginal Flora Disorders on Progression of Senile Cervical Intraepithelial Neoplasia

目的分析阴道菌群紊乱对老年宫颈上皮内瘤变(CIN)进展的影响。方法选取2018年1月至2020年2月盐城市第一人民医院妇产科收治的200例老年CIN患者作为研究对象,所有患者视自身情况给予合理的药物、物理、手术等个体化对症治疗。治疗3个月后,参照CIN分级标准评估CIN患者病变进展情况并分为进展组和未进展组。比较两组患者的人端粒酶逆转录酶(hTERT)水平及阴道菌群情况,并采用Logistic回归分析阴道菌群紊乱对老年CIN患者病变进展的影响。结果200例老年CIN患者经个体化对症治疗3个月后,病变进展共35例,进展率为17.50%。进展组的hTERT水平、阴道菌群紊乱患者比例均高于未进展组[(0.23±0.06)比(0.12±0.04)、57.14%(20/35)比33.33%(55/165)](P<0.01)。经Logistic回归分析显示,hTERT过表达、阴道菌群紊乱可能与老年CIN患者病变进展有关,可能作为CIN病变进展的风险因子,其中阴道菌群紊乱对CIN病变进展的影响更为显著(P<0.05)。结论老年CIN患者有较高的病变进展风险,可能与患者阴道菌群紊乱有关。

Objective To analyze the effect of vaginal flora disorders on the progression of cervical intraepithelial neoplasia(CIN)in the elderly.Methods A total of 200 elderly CIN patients admitted to Department of Obstetrics and Gynecology,Yancheng NO.1 People′s Hospital from Jan.2018 to Feb.2020 were included.All the patients according to their own situation were given reasonable drugs,physical,operational and other individualized symptomatic treatment.After 3 months of treatment,referring to CIN grading standards,the progression of CIN patients was assessed and they were assigned into a progressive group and a non-progressive group.The levels of human telomerase reverse transcriptase(hTERT)and vaginal flora of the two groups were compared,and the influence of vaginal flora disorder on the pathological progress of elderly patients with CIN was analyzed by Logistic regression.Results After 3 months of individualized symptomatic treatment,35 cases of CIN progressed,and the progress rate was 17.50%.The level of hTERT,the proportion of vaginal flora disorder of the progressive group were higher than those of the non-progressive group[(0.23±0.06)vs(0.12±0.04),57.14%(20/35)vs 33.33%(55/165)](P<0.01).Logistic regression analysis showed that hTERT overexpression,vaginal flora disorder might be related to the disease progression of the elderly CIN patients,which might be risk factors for the disease progression of CIN,and vaginal flora disorder had a more significant impact on the disease progression of CIN(P<0.05).Conclusion Elderly patients with CIN have a higher risk of disease progression,which may be related to the disorder of vaginal flora.