育龄期妇女阴道微生态平衡与宫颈息肉的相关性

Correction between vaginal microecological balance and cervical polyps in women of childbearing age

目的观察育龄期妇女阴道微生态平衡与宫颈息肉的相关性,旨在为宫颈息肉的预防提供参考意见。方法回顾性分析广西医科大学附属武鸣医院2019年1月至2020年12月收治89例宫颈息肉患者资料纳入宫颈息肉组;回顾性分析广西医科大学附属武鸣医院同期91例健康体检育龄期妇女的临床资料纳入对照组。记录2组研究对象阴道微生态指标,分析育龄期妇女阴道微生态平衡与宫颈息肉的关系,并检验阴道微生态指标对宫颈息肉发生风险的评估价值。结果初步比较宫颈息肉组、对照组研究对象阴道微生态指标后,经回归分析检验结果显示,育龄期妇女白细胞酯酶(LE)、唾液酸苷酶(SNA)、乙酰氨基葡萄糖苷酶(NAG)、清洁度、上皮细胞、白细胞、线索细胞、短杆菌及阴道微生态菌群异常与宫颈息肉的发生有关(OR=2.587、4.404、3.164、41.250、3.312、9.796、5.312、6.789、5.372,P=0.002、<0.001、0.005、<0.001、<0.001、<0.001、0.001、<0.001、0.033);Kendall′s W相关性分析检验结果显示,育龄期妇女LE、SNA、NAG、清洁度、上皮细胞、白细胞、线索细胞、短杆菌及阴道微生态菌群异常状况均与宫颈息肉发生呈正相关(r=0.333、0.278、0.316、0.449、0.389、0.424、0.357、0.373、0.331,均P<0.001);绘制受试者工作曲线(ROC),育龄期妇女LE、SNA、NAG、清洁度、上皮细胞、白细胞、线索细胞、短杆菌及阴道微生态菌群异常情况用于评估宫颈息肉发生的曲线下面积(AUC)分别为0.617、0.613、0.586、0.715、0.644、0.686、0.591、0.664和0.566,其中清洁度对宫颈息肉发生有中等评估价值,AUC>0.70。结论育龄期妇女阴道微生态平衡与宫颈息肉发生密切相关,LE、SNA、NAG、清洁度、上皮细胞、白细胞、线索细胞、短杆菌及阴道微生态菌群异常均与宫颈息肉发生有关,其中清洁度可用于评估宫颈息肉的发生,临床可根据患者阴道微生态平衡状况,制定针对性措施。

Objective To explore the correlation between vaginal microecological balance and cervical polyps(CPs)in women of childbearing age,aiming to provide reference for the prevention of cervical polyps.Methods The data of 89 patients with CPs(CP group)treated in our hospital from January 2019 to December 2020 were retrospectively analyzed,with 91 healthy women accepting physical examination in the same period as the control group.The vaginal microecological indexes were observed,the relationship between vaginal microecological balance and CPs in women of childbearing age was analyzed,and the value of vaginal microecological indexes in the evaluation of the risk of CPs was detected.Results After preliminary comparison of the vaginal microecology indexes of the CP group vs the control group,regression analysis showed that the abnormal leukocyte lipase(LE),sialidase(SNA),acetylglucosaminidase(NAG),cleanliness,epithelial cells,leukocytes,clue cells,Brevibacterium and vaginal microflora were related to the occurrence of CPs(OR=2.587,4.404,3.164,41.250,3.312,9.796,5.312,6.789,5.372;P=0.002,<0.001,0.005,<0.001,<0.001,<0.001,0.001,<0.001,0.033);Kendall′s W correlation analysis showed that LE,SNA,NAG,cleanliness,epithelial cells,leukocytes,clue cells,Brevibacterium and vaginal microflora were positively correlated with the occurrence of CPs(r=0.333,0.278,0.316,0.449,0.389,0.424,0.357,0.373,0.331,all P<0.001).The receiver operating curve(ROC)was drawn;the values of area under the curve(AUC)of LE,SNA,NAG,cleanliness,epithelial cells,leukocytes,clue cells,Brevibacterium and vaginal microflora in women of childbearing age in evaluating the occurrence of CPs were 0.617,0.613,0.586,0.715,0.644,0.686,0.591,0.664 and 0.566,respectively,among which cleanliness had moderate value for evaluation of the occurrence of CPs with an AUC value of>0.70.Conclusion Vaginal microecological balance is closely related to the occurrence of CPs in women of childbearing age.LE,SNA,NAG,cleanliness,epithelial cells,leukocytes,clue cells,Brevibacterium and abnormal vaginal microbiota are all related to the occurrence of CPs,among which cleanliness can be used to evaluate the occurrence of CPs.Clinically,targeted measures can be formulated according to the vaginal microecological balance of patients.