高危型HPV感染和宫颈癌前病变与阴道微生态的关系探讨

Discussion of the relationship between high-risk HPV infection and pre-cervical cancer lesions and vaginal micro-ecological discussions

目的分析高危型人乳头瘤病毒(HPV)感染和宫颈癌前病变与阴道微生态的关系。方法择取86例高危型HPV阳性的宫颈鳞状上皮内病变(SIL)患者为观察组;另择取86名HPV阴性的无宫颈病变受检者为对照组,两组均开展阴道微生态检查。比较两组阴道微生态平衡情况、阴道微生态各项指标水平。结果观察组的阴道微生态失衡、衣原体、解脲脲原体、霉菌、细菌性阴道炎、乳酸杆菌异常发生率(81.40%、25.58%、87.21%、86.05%、34.88%、34.88%)均显著高于对照组(34.88%、11.63%、29.07%、34.88%、9.30%、11.63%),差异有统计学意义(P<0.05)。观察组的优势菌为乳酸杆菌、菌群密集度正常、菌群多样性正常、清洁度正常、pH正常发生率均显著低于对照组,需氧菌性阴道炎(AV)、外阴阴道假丝酵母菌病(VVC)发生率均显著高于对照组,差异有统计学意义(P<0.05)。结论高危型HPV感染、宫颈癌前病变与阴道微生态环境失衡程度具有关联,阴道微生态指标与高危型HPV检测适用于宫颈病变发展的危险因素的监测,可为宫颈病变防治工作提供切实有效帮助。

Objective To analyze the relationship between high-risk human papillomavirus(HPV)infection,cervical precancer and vaginal microecology.Methods 86 patients with high-risk HPV-positive cervical squamous intraepithelial lesions(SIL)were selected as the observation group,and 86 HPV-negative patients without cervical lesions were selected as the control group.Vaginal microecological examination was performed in both groups.The balance of vaginal microecology and various indexes of vaginal microecology were compared between the two groups.Results The incidence of vaginal microecological imbalance,chlamydia,ureaplasma urealyticum,fungi,bacterial vaginitis and lactobacillus abnormalities in the observation group(81.40%,25.58%,87.21%,86.05%,34.88%,34.88%)were significantly higher than those in the control group(34.88%,11.63%,29.07%,34.88%,9.30%,11.63%),the difference was statistically significant(P<0.05).The dominant bacterium in the observation group was Lactobacillus,and the normal incidence of bacterial density,bacterial diversity,cleanliness and pH were significantly lower than those in the control group,while the incidence of AV and VVC were significantly higher than those in the control group,with statistical significance(P<0.05).Conclusion High-risk HPV infection and cervical precancerous lesions are associated with the imbalance of vaginal microecological environment.Vaginal microecological indicators and high-risk HPV detection are suitable for monitoring the risk factors for the development of cervical lesions,which can provide effective help for the prevention and treatment of cervical lesions.