重庆大学城区域高危型人乳头瘤病毒感染与阴道微生态失衡的关系研究

Relationship between high-risk human papillomavirus infection and vaginal microecology unbalance in Chongqing University Town area

目的探讨重庆大学城区域女性高危型人乳头瘤病毒(HPV)感染的分布及其与阴道微生态失衡的关系,为高危型HPV的防治提供依据。方法选取2021年1月至2022年8月在重庆医科大学附属大学城医院就诊并同时实施HPV和阴道微生态检测的787例女性为研究对象,分析HPV感染分布情况。按照是否检测到高危型HPV感染将研究对象分成高危型HPV阳性组和高危型HPV阴性组,比较两组阴道微生态状况并进行危险因素分析。结果HPV总感染率为14.23%,其中单一高危亚型感染78例,感染率为9.91%;多重高危亚型感染33例,感染率为4.19%。单一高危型感染者中以HPV52、16、58、18亚型为主。高危型HPV阳性组阴道微生态失衡中乳酸杆菌含量异常60例(54.05%)、pH值异常49例(44.14%)、过氧化氢酶阳性40例(36.04%)、细菌性阴道病(BV)36例(32.43%),与高危型HPV阴性组相比,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,乳酸杆菌含量异常、pH值异常、过氧化氢酶阳性和BV阳性是高危型HPV感染的独立危险因素(OR=2.070、1.766、1.601、1.613,P<0.05)。结论重庆大学城区域女性HPV感染主要以单一高危型感染为主,乳酸杆菌含量异常、pH值异常、过氧化氢酶阳性以及BV阳性为高危型HPV感染的危险因素,高危型HPV感染人群存在较高的阴道微生态失衡率,HPV的防治应综合考虑阴道微生态指标和HPV感染型别。

Objective To investigate the relationship between female high-risk human papillomavirus(HPV)infection and vaginal microecological unbalance in the Chongqing University Town area.Methods A total of 787 women visiting in the Affiliated University-Town Hospital of Chongqing Medical University and simultaneously implementing HPV and vaginal microecological examination from January 2021 to August 2022 were selected as the study subjects.The HPV infection distribution situation was analyzed.According to whether high-risk HPV infection was detected,the study subjects were divided into high-risk HPV positive group and high-risk HPV negative group,the vaginal microecological status of the two groups was compared and the risk factors were analyzed.Results The total infection rate of HPV was 14.23%,in which there were 78 cases of single high-risk subtype infection with an infection rate of 9.91%,there were 33 cases of high-risk subtype multiple infection with an infection rate of 4.19%.The patients infected with the single high-risk HPV were mainly HPV52,16,58 and 18 subtypes.In the high-risk HPV positive group with microecological unbalance,there were 60 cases(54.05%)of lactobacillus content abnormality,49 cases(44.14%)of pH value abnormality,40 cases(36.04%)of catalase positive,36 cases(32.43%)of bacterial vaginosis(BV),compared with the high-risk HPV negative group,and the differences were statistically significant(P<0.05).The Logistic regression analysis showed that the lactobacilli abnormality,pH value abnormality,catalase positive and BV positive were the independent risk factors of high-risk HPV infection(OR=2.070,1.766,1.601,1.613,P<0.05).Conclusion The female HPV infection in Chongqing University Town area is mainly the single high risk type infection.The lactobacilli abnormality,pH value abnormality,catalase positive and BV positive are the risk factors of high-risk HPV infection.The population with high-risk HPV infection has the higher vaginal microecological unbalance rate.The prevention and treatment of HPV should comprehensively consider the vaginal microecology indicators and the types of HPV infection.