盆腔器官脱垂患者阴道微环境与HPV感染的相关性研究进展

Research progress on the correlation between vaginal microenvironment and HPV infection in patients with pelvic organ prolapse

随着人口老龄化及人们生活水平的提高,盆腔器官脱垂(POP)的患病率呈逐年上升趋势。在对POP患者的诊治过程中不难发现合并人乳头瘤病毒(HPV)感染及宫颈病变的病例。该文对POP患者阴道微环境的变化与HPV感染的相关性研究进行了综述,发现POP患者因脱出的盆底器官组织等长期暴露于周围不洁环境导致阴道炎发生的可能性增加,同时因雌激素水平降低、乳酸杆菌数量减少、阴道pH值升高、全身免疫及阴道内局部免疫力降低等导致阴道微环境发生明显变化,这一系列因素共同作用可能导致POP患者感染高危型HPV的风险性增加。持续性的高危型HPV感染是导致宫颈癌发生的高危因素,而宫颈癌是作为女性致死率最高的三大恶性肿瘤之一,严重威胁着女性的健康。因此临床上在对POP患者的治疗过程中应注意对其阴道微环境进行健康管理,防范HPV感染导致的严重结局发生,进一步提高患者生活质量。

With the aging of the population and the improvement of people′s living standards,the prevalence of pelvic organ prolapse(POP)is increasing year by year.In the diagnosis and treatment of POP patients,it is not difficult to find cases with human papilloma virus(HPV)infection and cervical lesions.This article reviewed the correlation between the changes of vaginal microenvironment and HPV infection in POP patients.The results showed that POP patients were more likely to suffer from vaginitis due to the long-term exposure of prolapsed pelvic floor organs and tissues to the surrounding unclean environment.At the same time,the vaginal microenvironment changed significantly due to the decrease of estrogen level,the decrease of lactobacillus number,the increase of vaginal potential of hydrogen(PH)value,the decrease of systemic immunity and local immunity in the vagina.The combination of these factors may increase the risk of POP patients infected with high-risk HPV.Persistent high-risk HPV infection is a high-risk factor leading to cervical cancer,and cervical cancer is one of the three malignant tumors with the highest mortality rate among women,which seriously threatens the health of women.Therefore,in the clinical treatment of POP patients,attention should be paid to the health management of their vaginal microenvironment to prevent serious consequences caused by HPV infection,and further improve the quality of life of patients.