阴道微生态与高危型人乳头瘤病毒感染及宫颈病变的相关性

Correlation between vaginal microecology and high risk-human papillomavirus infection as well as cervical lesions

目的探讨阴道微生态与高危型人乳头瘤病毒(HR-HPV)感染及宫颈病变的相关性。方法收集2019年1月至6月门诊患者1269例,进行阴道微生态和宫颈HPV及液基细胞学(TCT)检测,将研究对象分为HR-HPV组、非HR-HPV组和宫颈病变组、宫颈正常组,比较组间阴道微生态失衡发生率、阴道菌群阳性率。结果HR-HPV组阴道微生态失衡发生率高于非HR-HPV组(P<0.05),宫颈病变组阴道微生态失衡发生率高于宫颈正常组,但差异无统计学意义(P>0.05)。HR-HPV组细菌性阴道病、滴虫性阴道炎、外阴阴道假丝酵母菌病阳性率均高于非HR-HPV组,差异有统计学意义(P<0.05)。宫颈病变组细菌性阴道病阳性率高于宫颈正常组,差异有统计学意义(P<0.05)。细菌性阴道病是影响HPV感染的危险因素[OR=1.55,95%CI(1.07,2.23),P<0.05],也是影响宫颈病变的危险因素[OR=2.45,95%CI(1.54,3.91),P<0.05]。结论阴道微生态失常者可能增加HR-HPV感染及宫颈病变概率。

Objective To investigate the correlation between vaginal microecology and high risk-human papillomavirus infection as well as cervical lesions.Methods A total of 1269 patients who visited our hospital from January 2019 to June 2019 were enrolled in the study,who were divided into HR-HPV positive group,HR-HPV negative group,cervical lesions group and normal cervical group.and the incidence of vaginal microecological abnormality and the positive rate of vaginal flora were observed and compared among the four groups.Results The incidence of vaginal microecological abnormality in HR-HPV group was significantly higher than that in HR-HPV negative group(P<0.05),moreover,which in cervical lesions group was significantly higher than that in normal cervical group(P>0.05).The detection rates of BV,TV and VVC in HR-HPV positive group were significantly higher than those in HR-HPV negative group(P<0.05).The positive rate of bacterial vaginitis in cervical lesion group was significantly higher than that in normal cervical group(20.7%VS 9.5%,P<0.05).Moreover the bacterial vaginitis was a risk factor affecting HPV infection(P<0.05),which was also a risk factor affecting cervical lesions(P<0.05).Conclusion The vaginal microecological abnormality can increase the infection rate of HR-HPV and the incidence of cervical lesions.