100例高危型人乳头瘤病毒感染患者临床特征及中西医治疗效果分析

Clinical characteristics and therapeutic effects of traditional Chinese and Western medicine on 100 high-risk patients with human papillomavirus infection

目的分析上海地区高危型人乳头瘤病毒流行特点及中西医治疗高危型人乳头瘤病毒疗效。方法选取上海地区进行宫颈癌筛查中确诊感染高危型人乳头瘤病毒(high risk human papilloma virus,HR-HPV)的100例女性患者为研究对象,同时随机选取100例同期宫颈癌筛查健康的女性为对照组。使用一次性宫颈细胞采集刷采集患者宫颈上皮脱落细胞,采用人乳头瘤病毒分型核酸测定试剂盒提取核酸,然后进行PCR扩增,选择荧光检测通道并设定相关参数进行检测、观察,对检测结果进行分析、判读,检测标本中15种HR-HPV核酸DNA(包括HPV16、HPV18、HPV31、HPV33、HPV35、HPV39、HPV45、HPV51、HPV52、HPV53、HPV56、HPV58、HPV59、HPV66、HPV68)。采集研究组和对照组女性宫颈阴道分泌物进行阴道指标检测,包括乳酸杆菌、细菌性阴道炎、衣原体、支原体、滴虫。将100例HR-HPV感染患者随机分为2组,每组各50例。第一组患者给予重组人干扰素α-2b阴道泡腾胶囊治疗,第二组患者在给予重组人干扰素α-2b阴道泡腾胶囊治疗基础上加用康复新液,用药三个月。对两种不同治疗方案患者的治疗效果、HPV转阴率、免疫功能、炎症指标进行对比分析。结果100例HR-HPV感染患者中,11.00%患者≤30岁,33.00%患者30~40岁,30.00%患者41~50岁,26.00%患者>50岁。58.00%为单一亚型感染,23.00%为两种亚型混合感染,19.00%为三种及三种以上亚型混合感染。常见15种HR-HPV亚型均有检出,主要为HPV16、HPV18、HPV31型。对比100例感染HR-HPV女性与同期100例健康女性的阴道菌群特点,乳酸杆菌异常率、细菌性阴道炎检出率、衣原体检出率、支原体检出率、滴虫检出率差异有统计学意义(均P<0.05)。感染HPV16、HPV18、其他HPV型,各组乳酸杆菌异常率、细菌性阴道炎检出率、衣原体检出率、支原体检出率、滴虫检出率差异无统计学意义(均P>0.05)。不同治疗方案患者的治疗显效率、无效率、HPV转阴率差异有统计学意义(均P<0.05),治疗有效率差异无统计学意义(均P>0.05)。不同治疗方案治疗后血清CD4、CD8+T细胞百分率差异有统计学意义(均P<0.05),治疗前血清差异无统计学意义(均P>0.05)。两种不同治疗方案患者治疗后血清IL-4、IL-6水平差异有统计学意义(P<0.05),治疗前差异无统计学意义(均P>0.05)。结论上海地区HR-HPV感染患者以30~50岁女性居多,主要为HPV16、HPV18型,对阴道菌群环境影响较大。重组人干扰素α-2b阴道泡腾胶囊结合康复新液治疗方案能提高HPV转阴率和患者免疫功能。

Objective The epidemic characteristics of high-risk human papillomavirus in Shanghai and the efficacy of traditional Chinese and Western medicine in treating high-risk human papillomavirus were analyzed.Methods Clinical data of 100 female patients diagnosed with high-risk human papillomavirus infection during cervical cancer screening in Shanghai were selected as the study subjects,and 100 healthy women with cervical cancer screening results during the same period were randomly selected as the study control group.The cervical epithelial cells were collected by a disposable cervical cell collection brush from patients,The nucleic acid were extracted by a human papillomavirus typing nucleic acid assay kit,and then perform PCR amplification.The fluorescence detection channel were selected,and the relevant parameters were set for detection and observation.Then detection results were analyzed and interpreted.15 types of HR-HPV nucleic acid DNA(including HPV16,HPV18,HPV31,HPV33,HPV35,HPV39,HPV45,HPV51,HPV52,HPV53,HPV56,HPV58,HPV59,HPV66,HPV68)were detected in the samples.The cervical and vaginal secretions from women in the research and control groups were collected for vaginal indicators testing,including lactobacilli,bacterial vaginitis,chlamydia,mycoplasma,and trichomonas.100 patients with HR-HPV infection were randomly divided into two groups,with 50 cases in each group.The first group of patients received recombinant human interferonα-2b vaginal effervescent capsule treatment,the second group of patients received recombinant human interferonα-2b vaginal effervescent capsule treatment and Kangfuxin solution,and the treatment was for three months.Compare and analyze the treatment efficacy,HPV negative conversion rate,immune function,and inflammatory indicators of two different treatment plans for patients.Results Among 100 patients with HR-HPV infection,11.00%were≤30 years old,33.00%were 30-40 years old,30.00%were 41-50 years old,and 26.00%were>50 years old.58.00%were single subtype infections,23.00%were mixed infections of two subtypes,and 19.00%were mixed infections of three or more subtypes.15 common subtypes of HR-HPV have been detected,mainly HPV16,HPV18,and HPV31.The comparison of vaginal microbiota characteristics,abnormal rate of lactobacilli,detection rate of bacterial vaginitis,detection rate of chlamydia,detection rate of mycoplasma,and detection rate of trichomonas between 100 women infected with HR-HPV and 100 healthy women during the same period was statistically significant(all P<0.05).There was no statistically significant difference in the abnormal rate of Lactobacillus,detection rate of bacterial vaginitis,detection rate of Chlamydia,detection rate of Mycoplasma,and detection rate of Trichomonas among the groups infected with HPV16,HPV18,and other HPV types(all P>0.05).There were statistically significant differences in the treatment efficacy,inefficiency,and HPV conversion rate among patients with different treatment plans(all P<0.05),while there was no statistically significant difference in the treatment efficacy rate(all P>0.05).There was a statistically significant difference in the percentage of CD4 and CD8~+T cells in serum after treatment with different treatment regimens(all P<0.05),while there was no statistically significant difference in serum before treatment(all P>0.05).There was a statistically significant difference in serum IL-4 and IL-6 levels between two different treatment regimens after treatment(P<0.05),but there was no statistically significant difference before treatment(all P>0.05).Conclusion The majority of HR-HPV infected patients in Shanghai were women aged 30-50,mainly HPV16 and HPV18,which have a significant impact on the vaginal microbiota environment.Recombinant human interferonα-2b vaginal effervescent capsule and Kangfuxin liquid treatment regimen can effectively improve the HPV negative conversion rate and immune function.