阴道微环境及白介素-4与宫颈高危型人乳头状瘤病毒感染的相关研究

Study on the Relationship between Vaginal Microenvironment,Interleukin-4 and High-Risk HPV Infection of the Cervix

目的:研究阴道微环境及白介素-4(IL-4)与宫颈高危型人乳头状瘤病毒(HR-HPV)感染的关系。方法:选取2018年12月至2019年12月大理大学第一附属医院就诊的宫颈HR-HPV感染的育龄期患者85例为观察组(A组),同期体检宫颈HPV阴性者83例为对照组(B组)。比较不同年龄段女性感染HR-HPV情况,检测阴道微环境及阴道灌洗液中IL-4水平,分析HR-HPV感染与常见阴道炎的关系,并进行多变量Logistic回归分析。结果:HR-HPV感染者中,年龄≤25岁及>45岁者感染率较26~45岁者高,差异有统计学意义(P<0.05);A组与B组阴道微环境相关指标和阴道灌洗液中IL-4水平比较差异有统计学意义(P<0.05);A组滴虫性阴道炎和细菌性阴道病阳性率高于B组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,乳酸杆菌、滴虫性阴道炎、细菌性阴道病、白细胞酯酶均是HR-HPV感染的独立危险因素。结论:HR-HPV感染存在年龄分布特点,阴道微环境及阴道灌洗液中IL-4水平升高与其分型密切相关。

Objective:To study the relationship between vaginal microenvironment,interleukin-4(IL-4)and high-risk human papilloma virus(HR-HPV)infection of the cervix.Methods:From December 2018 to December 2019,85 patients of childbearing age with cervical HR-HPV infection who were admitted to the First Affiliated Hospital of Dali University were selected as the observation group(Group A),and 83 patients with cervical HPV-negative physical examination during the same period were selected as the control group(Group B).The HR-HPV infections in women of different ages were compared,the vaginal microenvironment and the level of IL-4 in vaginal lavage fluid were detected,and the relationship between HR-HPV infection and common vaginitis was analyzed by multivariate Logistic regression analysis.Results:Among HR-HPV infected persons,the infection rate of persons≤25 years old and>45 years old was higher than that of persons 26 to 45 years old,and the difference was statistically significant(P<0.05).There were significant differences in vaginal microenvironmental indicators and the level of IL-4 in vaginal lavage fluid between Group A and Group B(P<0.05).The positive rates of trichomonas vaginitis and bacterial vaginosis in Group A were higher than those in Group B,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that Lactobacillus,trichomonas vaginitis,bacterial vaginosis,and leukocyte esterase were all independent risk factors for HR-HPV infection.Conclusion:There is age distribution characteristics in HR-HPV infection.The vaginal microenvironment and the increase of IL-4 level in vaginal lavage fluid are closely related to its classification.