高危型人乳头瘤病毒感染与阴道微环境变化的相关性

Correlation between high risk human papillomavirus infection and vaginal microenvironment

目的研究高危型人乳头瘤病毒(HR-HPV)感染与阴道微环境变化的关系。方法抽取2019年10月至2020年10月于厦门市中医院妇科门诊进行检查的220例妇女作为研究对象,采集其宫颈分泌物标本,进行液基细胞学检测及HR-HPV感染检测,根据有无HR-HPV感染分为阳性组(70例)与阴性组(150例)。比较两组阴道微环境相关指标,分析HR-HPV感染与阴道微环境变化的相关性。结果HR-HPV阳性组乳酸杆菌数量、阴道清洁度与阴性组比较差异有统计学意义(P<0.05)。HR-HPV阳性组外阴阴道假丝酵母菌病(VVC)、细菌性阴道炎(BV)发生率分别为21.43%(15/70)、14.29%(10/70),高于HR-HPV阴性组的10.00%(15/150)、5.33%(8/150),P<0.05。HR-HPV阳性组过氧化氢、白细胞酯酶、唾液酸苷酶阳性率与阴性组比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,BV、乳酸杆菌量过少或缺乏是HR-HPV感染的独立影响因素(P<0.05)。结论HR-HPV感染与阴道微环境变化密切相关,BV、乳酸杆菌量缺乏或过少是导致HR-HPV感染的独立影响因素。

Objective To investigate the correlation between high-risk human papillomavirus(HR-HPV)infection and vaginal microenvironment.Methods A total of 220 gynecological outpatients in Xiamen Hospital of Traditional Chinese Medicine from October 2019 to October 2020 were selected as the research objects.Cervical secretion samples were collected from them for the liquid-based cytology test and HR-HPV infection test.According to the occurrence of HR-HPV infection,they were divided into positive group(70 cases)and negative group(150 cases).The vaginal microenvironment-related indexes of the two groups were compared,and the correlation between HR-HPV infection and changes of vaginal microenvironment was analyzed.Results There were significant differences in the number of Lactobacillus and vaginal cleanliness between positive group and negative group(P<0.05).The incidence of vulvovaginal candidiasis(VVC)and bacterial vaginitis(BV)in positive group were 21.43%(15/70)and 14.29%(10/70),respectively,higher than the 10.00%(15/150)and 5.33%(8/150)in negative group(P<0.05).There were significant differences in the positive rate of hydrogen peroxide,leukocyte esterase and sialidase between HR-HPV positive group and negative group(P<0.05).Results of multivariate Logistic regression analysis showed that BV and deficiency or inadequacy of Lactobacillus were independent influencing factors of HR-HPV infection(P<0.05).Conclusions HR-HPV infection is closely related to the changes of vaginal microenvironment.BV and the deficiency or inadequacy of Lactobacillus are the independent factors leading to HR-HPV infection.