阴道微生态与宫颈HPV感染患者炎性因子和T细胞亚群的相关性分析

Correlation of vaginal microecology with inflammatory factors and T cell subsets in patients with cervical HPV infection

目的分析阴道微生态与宫颈感染人乳头瘤病毒(HPV)患者炎性因子、T细胞亚群的相关性。方法选取120例宫颈感染HPV患者作为观察组,另选取95例同期体检健康女性作为对照组,观察2组阴道菌群情况、T细胞亚群水平(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、IFN-γ和IL-4等炎性因子水平。观察组根据患者阴道微生态情况又分为阴道微生态失衡组和阴道微生态正常组,比较两组T细胞亚群和炎性因子水平;ROC曲线评估T细胞亚群和炎性因子预测阴道微生态失调的价值;采用Spearman相关性分析分析阴道菌群失调与HPV感染患者T细胞亚群变化和炎性因子水平的关系。结果观察组阴道微生态失衡率明显46.7%高于对照组6.3%(P<0.05);观察组CD4^(+)T细胞、CD4^(+)/CD8^(+)、IFN-γ水平均较对照组低,CD8^(+)T细胞、IL-4水平均较对照组高(P<0.05);阴道微生态失衡者CD4^(+)T细胞、CD4^(+)/CD8^(+)和IFN-γ水平低于阴道微生态正常者,而CD8^(+)T细胞、IL-4水平高于阴道微生态正常者(P<0.05);血清IFN-γ、IL-4、CD4^(+)T细胞、CD8^(+)T细胞、CD4^(+)/CD8^(+)联合预测HPV感染患者阴道微生态失衡的AUC为0.972,灵敏度、特异度分别为85.7%、98.4%;Spearman相关性分析显示,HPV感染患者血清IFN-γ、IL-4、CD4^(+)T细胞、CD8^(+)T细胞、CD4^(+)/CD8^(+)水平与阴道菌群失调呈正相关(P<0.05)。结论HPV感染患者阴道微生态失衡,出现免疫功能紊乱和炎症反应,血清T细胞亚群和炎性因子与患者阴道微生态失衡有相关性,在一定程度上能预测HPV感染患者阴道微生态失衡的发生。

Objective To analyze the correlation between vaginal microecology and inflammatory factors and T cell subsets in patients with cervical human papillomavirus(HPV)infection.Methods One hundred and twenty patients with cervical HPV infection were selected as the observation group,with 95 healthy women as the control group.The levels of vaginal flora,T-cell subset levels(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),inflammatory factor IFN-γand IL-4 were observed in the two groups.According to the vaginal microecological occassions in the observation group,the patients were divided into two groups:the disorder group and the normal group.The levels of T-cell subsets and inflammatory factors were compared between the two subgroups,and ROC curves were dotted to assess the value of T-cell subsets and inflammatory factors in predicting vaginal dysbiosis.Spearman correlation was used to analyze the relationship between vaginal flora imbalance and T-cell subsets and inflammatory factors in patients with HPV infection.Results The rate of vaginal dysbiosis in observation group was 46.7%,higher than the 6.3%in control group(P<0.05).The levels of CD4^(+)T cell,CD4^(+)/CD8^(+)and IFN-γin the observation group were lower,while those of CD8^(+)T cell and IL-4 were higher than those in the control group,respectively(P<0.05).The levels of CD4^(+)T cell,CD4^(+)/CD8^(+)and IFN-γwere lower in patients with vaginal dysbiosis,while CD8^(+)T cell and IL-4 were higher than in normal group,respectively(P<0.05).The AUC of serum IFN-γ,IL-4,CD4^(+)T cell,CD8^(+)T cell and CD4^(+)/CD8^(+)to jointly predict vaginal dysbiosis in HPV-infected patients was 0.972,with sensitivity and specificity of 85.7%and 98.4%respectively.Spearman correlation analysis showed that serum levels of IFN-γ,IL-4,CD4^(+)T cell,CD8^(+)T cell and CD4^(+)/CD8^(+)were positively correlated with vaginal dysbiosis in HPVinfected patients(P<0.05).Conclusion HPV infected patients have vaginal microecology imbalance,immune dysfunction and inflammatory reaction.Serum T cell subsets and inflammatory factors are related to vaginal dysbiosis,which can predict the occurrence of vaginal dysbiosis in patients with HPV infection to a certain extent.