宫颈高危型人乳头瘤病毒感染患者的阴道微生态分析
摘要
目的分析感染高危型人乳头瘤病毒(HR-HPV)患者阴道微生态失衡情况,为临床处理人乳头瘤病毒感染,纠正阴道微生态失衡提供理论参考。方法选取2015年12月至2017年6月该院门诊就诊的宫颈HR-HPV阳性,宫颈液基细胞学阴性患者(132例)为观察组,选取同期门诊就诊的健康妇女(136例)为对照组,分别取阴道分泌物检测阴道菌群失衡情况,分析HR-HPV与各类阴道微生态异常的关系,结果采用SPSS20.0软件进行统计分析。结果 (1)两组阴道微生态失衡情况:研究组与对照组中,乳酸杆菌减少、pH>4.5,细菌性阴道炎(BV)检出率比较差异有统计学意义(P<0.05),需氧菌性阴道炎(AV)、滴虫性阴道炎(TV)及外阴阴道假丝酵母菌病(VVC)及白细胞增多的检出率,两组比较差异无统计学意义(P>0.05)。同时BV阳性组与BV阴性组HR-HPV检出率比较,差异有统计学意义(P<0.05),其余各组间比较差异无统计学意义(P>0.05);(2)研究组中单一型别HR-HPV感染86例,2种及以上HR-HPV感染46例,其中BV的检出率,两组比较差异有统计学意义(P<0.05)。其余指标比较差异无统计学意义(P>0.05)。结论阴道乳酸杆菌减少、BV阳性与HR-HPV感染明显相关,临床处理HR-HPV持续感染时,要充分考虑并评估患者阴道微生态。
引文
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[18]夏玉洁,王辰,王颖梅,等.阴道微生态异常与高危型人乳头瘤病毒感染的相关性研究[J].中国妇产科临床杂志,2017,18(2):131-133.
[2]RODRIGUEZ A C,SCHIFFMAN M,HERRERO R,et al.Longitudinal study of human papillomavirus persistence and cervical intraepithelial neoplasia grade 2/3:critical role of duration of infection[J].J Natl Cancer Inst,2010,102(5):315-324.
[3]BROTMAN R M.SHARDELL M D,GAJER P,et al.Interplay between the temporal dynamics of the vaginal microbiota and human papillmavirus detection[J].J Infect Dis,2014,210(11):1723-1733.
[4]AMEUR A,MEIRING T L,BUNIKIS I,et al.Comprehensive profiling of the vaginal microbiome in HIV postive women using massive parallel semiconductor sequencing[J].Sci Rep,2014(4):4398.
[5]李科珍,金鑫,方勇,等.HPV16整合状态与宫颈癌发生的相关性研究[J].中国妇幼保健,2011,26(27):4241-4244.
[6]余晓梅.宫颈环形电切除术(LEEP)治疗宫颈上皮内瘤变的疗效观察[J].中外医疗,2013,32(11):107-108.
[7]阎立爽,陈艳鸿,闫金凤.宫颈电圈切除术(LEEP)治疗慢性宫颈炎368例疗效分析[J].中国妇科临床杂志,2012,7(1):44-46.
[8]MAYER B T,SRINIVASAN S,FIEDLER T L,et al.Rapid and profound shifts in the vaginal microbiota following antibiotic treatment for bacterial caginosis[J].JInfect Dis,2015,212(5):793-802.
[9]肖冰冰,廖秦平.阴道微生态研究进展[J].国际妇产科学杂志,2011,38(6):479-482.
[10]王美藏,高建宏,杨雅琴,等.HPV感染患者阴道菌群与宫颈局部免疫功能的相关性研究[J].河北医科大学学报,2018,39(1):104-107.
[11]汪群水,周学琴,李丽民,等.细菌性阴道炎和HPV感染与宫颈癌的关系分析[J].浙江临床医学,2015,17(12):2189-2190.
[12]柳双燕,李瑞珍.深圳女性生殖道HR-HPV感染与常见阴道病原体感染的关系[J].吉林医学,2011,32(14):2787-2789.
[13]GILLET E,MEYS J F,VERSTRAELEN H,et al.Bacterial vaginosis is associated with uterine cervical human papillomavirus infection:a meta-analysis[J].BMC Infect Dis,2011,11(1):10.
[14]李启松,崔玉宝.炎症促进肿瘤发生发展的研究进展[J].医学综述,2015,8,21(16):2918-2920.
[15]CASTLE P,HILLIER S,RALE L,et al.An association of cervical infalmmation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus(HPV)[J].Cancer Epidemilo Biomarkers Prev,2001,10(10):1021-1027.
[16]MURTA E,SOUZA M,ARAU J,et al.Incidence of Gardnerel lavaginalis,candidasp and human papillomavirus in cytological smears[J].Sao Paulo Med J,2000,118(4):105-108.
[17]VIEIRA-BAPTISTS P,LIMA-SILVA J,PINTO C,et al.An association of cervical inflammation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus(HPV)[J].Cancer Epidemiol Biomarkers Prev,2001,10(10):1021-1027.
[18]夏玉洁,王辰,王颖梅,等.阴道微生态异常与高危型人乳头瘤病毒感染的相关性研究[J].中国妇产科临床杂志,2017,18(2):131-133.