宫颈HR-HPV感染与阴道菌群失调及酸碱度的关系研究

Study on the Relationship between Cervical HR-HPV Infection and Vaginal Flora Imbalance and pH

目的探讨宫颈宫颈高危型人乳头瘤病毒(high-riskhumanpapillomavirus,HR-HPV)感染与阴道菌群失调、阴道酸碱度的关系。方法选取2019年4-8月上海市普陀区人民医院妇科门诊要求体检的女性102例为研究对象,根据是否感染宫颈HR-HPV分为HPV阳性组(37例)和HPV阴性组(65例),根据阴道细菌16SrRNA的V3+V4区高通量测序结果将阴道菌群结构分为乳酸杆菌优势型(79例)、厌氧菌优势型(17例)和无优势菌型(6例),比较分析宫颈HR-HPV感染、阴道菌群及酸碱度三者之间的关系。结果两组阴道菌群丰度和多样性相似,都主要以乳酸杆菌组成(73.60%vs 75.37%);HPV阳性组较HPV阴性组加德纳菌、小球藻、斯内西亚菌、奇异菌等厌氧菌过度生长,但差异无统计学意义(P>0.05)。随乳酸杆菌减少阴道pH升高,乳酸菌优势型与无乳酸菌优势型相比[10.13%(8/79)vs 60.87%(14/23)],差异有统计学意义(χ^(2)=24.197,P<0.001);HPV感染[35.44%(28/79)vs 39.13%(9/23)],差异无统计学意义(χ^(2)=0.105,P=0.746)。随阴道pH升高HPV感染率增加[50.00%(11/22)vs 32.50%(26/80)],差异无统计学意义(χ^(2)=2.286,P=0.131)。结论宫颈HR-HPV感染、阴道多菌性菌群失调都与阴道酸碱度升高有关,可能是阴道酸碱度长期升高导致杀菌能力不足的结果。

Objective To investigate the relationship between cervical high-risk human papillomavirus(HR-HPV)in⁃fection and vaginal flora imbalance and vaginal pH.Methods 102 women who were required to undergo physical ex⁃amination in the gynecological outpatient department of Shanghai Putuo District People's Hospital from April to Au⁃gust 2019 were selected as the study objects.They were divided into HPV positive group(37 cases)and HPV negative group(65 cases)according to whether they were infected with cervical HR-HPV.According to the high throughput sequencing results of the V3+V4 region of vaginal bacterial 16SrRNA,the vaginal flora was divided into lactobacilli dominant(79 cases),anaerobic dominant(17 cases)and non-dominant(6 cases).The relationship among cervical HR-HPV infection,vaginal flora and pH was compared and analyzed.Results The abundance and diversity of the two groups of vaginal flora were similar,both of which were composed of lactobacillus(73.60%vs 75.37%);the HPV-positive group was more than HPV negative group in the Gedner,small ball algae,Sneisian bacteria,strange⁃ness,and strangeness Aegis and other anaerobic bacteria grow,but the difference was not statistically significant(P>0.05).With the increase of vaginal pH with lactobacillus,compared with lactobacilli dominant and non-lactobacilli dominant[10.13%(8/79)vs 60.87%(14/23)],the difference was statistically significant(χ^(2)=24.197,P<0.001);HPV infection[35.44%(28/79)vs 39.13%(9/23)],the difference was not statistically significant(χ^(2)=0.105,P=0.746).The infection rate of HPV in vaginal pH increased by[50.00%(11/22)vs 32.50%(26/80)],and the difference was not sta⁃tistically significant(χ^(2)=2.286,P=0.131).Conclusion Cervical HR-HPV infection and vaginal polybacterial flora im⁃balance are related to the increase of vaginal pH,which may be the result of insufficient sterilization ability caused by long-term increase of vaginal pH.