高危型HPV感染与阴道微生态环境的相关性分析

Correlation Analysis between High-Risk HPV Infection and Vaginal Microecological Environment

目的研究高危型HPV感染与阴道微生态环境的相关性。方法随机收集2020年12月—2021年12月于西电集团医院妇产门诊进行妇科健康体检的280名女性的体检资料进行分析,以有无感染高危型HPV为依据将患者分为病例组和对照组,病例组高危型HPV阳性153例,对照组高危型HPV阴性127例。分析比较两组阴道菌群密集度、多样性、pH、阴道微生态功能检测、阴道病原微生物以及Nugent评分。结果两组阴道菌群密集度、多样性相比,差异无统计学意义(P>0.05);病例组阴道pH≥4.5者占比、过氧化氢酶阳性率、唾液酸苷酶阳性率、白细胞酯酶阳性率均高于对照组,差异均有统计学意义(P<0.05)。在全部280例受试者中,细菌性阴道病(BV)检出率为20.00%(56/280),滴虫性阴道炎(TV)检出率为1.43%(4/280),外阴阴道假丝酵母菌(VVC)检出率为5.00%(14/280)。其中病例组BV阳性率为33.33%(51/153),对照组BV阳性率为3.94%(5/127),组间比较,差异有统计学意义(P<0.05)。病例组TV阳性率、VVC阳性率与对照组相比,差异无统计学意义(P>0.05)。采用二元logistics回归分析显示,随着Nugent评分的升高,高危型HPV感染的风险升高4.986~6.791倍(χ_(1)^(2)=21.489,P_(1)<0.05,OR_(1)=4.986,95%CI_(1):2.424~10.258;χ_(2)^(2)=17.573,P_(2)<0.05,OR_(2)=6.791,95%CI_(2):2.503~18.420)。结论高危型HPV感染与阴道微生态环境存在相关性,其中BV是HPV高危型感染的风险因素。

Objective To study the correlation between high-risk HPV infection and vaginal microecological environment.Methods A total of 280 women with gynecological outpatient health checkups,subjects aged 20~60 years,were randomly collected and divided into case and control groups,grouped based on the presence or absence of high-risk HPV infection.The case group:153 cases were positive for high-risk HPV,and the control group:127 cases were negative for HPV.The vaginal flora density,diversity,pH value,vaginal microecological function test,vaginal pathogenic microorganisms,and Nugent score were analyzed and compared between the two groups.Results The difference in the density and diversity of vaginal flora between the case group and the control group was not statistically significant(P>0.05);In the case group,the proportion of vaginal pH 4.5,catalase positive rate,sialidase positive rate and leukocyte esterase positive rate were all higher than the control group,and the differences were statistically significant(P<0.05).The BV detection rate was 20.00%(56/280),TV detection rate was 1.43%(4/280),and VVC detection rate was 5.00%(14/280)in all 280 subjects.The BV positivity rate was 33.33%(51/153)in the case group and 3.94%(5/127)in the control group,with a significant difference between the groups(P<0.05).There were no significant differences in the rates of trichomonas vaginalis and Pseudomonas vulvae positivity in the case group compared with the control group(P>0.05).The risk of high-risk HPV infection increased 4.986-6.791-fold with increasing Nugent score(χ_(1)^(2)=21.489,P_(1)<0.05,OR_(1)=4.986,95%CI_(1):2.424-10.258;χ_(2)^(2)=17.573,P_(2)<0.05,OR_(2)=6.791,95%CI_(2):2.503-18.420).Conclusion High risk HPV infection is closely related to vaginal microecology,especially BV is a risk factor for high risk HPV infection.