阴道微环境改变与高危型人乳头瘤病毒感染的相关性
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摘要
目的探讨阴道微环境改变与高危型人乳头瘤病毒(HR-HPV)感染的相关性。方法选择2016年1月至2017年5月来东莞市塘厦医院妇科门诊就诊的宫颈细胞学检测阴性的患者2 945例,分析其阴道微环境改变与HR-HPV感染的相关性。结果 2 945例标本中阴道微环境改变1 957例(66.45%),其中HRHPV感染384例(19.62%),与阴道微环境正常者比较HR-HPV感染率差异有统计学意义(P<0.05)。需氧菌性阴道炎(AV)302例(15.43%),细菌性阴道炎(BV)578例(29.54%),外阴阴道假丝酵母菌性阴道炎(VVC)276例(14.10%),滴虫性阴道炎(TV)225例(11.50%),单纯过氧化氢(H_2O_2)缺乏246例(12.57%),单纯H_2O_2和白细胞酯酶(LE)阳性330例(16.86%),混合性阴道炎439例(22.43%),AV、BV、VVC、TV、单纯H_2O_2缺乏、单纯H_2O_2和LE阳性、混合性阴道炎中HR-HPV感染分别为78例(25.83%)、184例(31.86%)、83例(30.11%)、56例(24.92%)、62例(25.24%)、94例(28.48%)、215例(48.97%),以上各类型与阴道微环境正常者HR-HPV感染率比较差异均有统计学意义(P<0.05);BV、VVC与其他类型阴道微环境改变者HR-HPV感染率差异有统计学意义(P<0.05),AV、TV与其他类型阴道微环境改变组HR-HPV感染率差异无统计学意义(P>0.05);混合性阴道炎与各类HR-HPV感染率比较差异均有统计学意义(P<0.05)。结论 AV、BV、VVC、TV、单纯H_2O_2缺乏、单纯H2O2和LE阳性与HR-HPV感染有关。
Objective To investigate the correlation between the change of vaginal microenvironment and high-risk human papillomavirus(HR-HPV)infection.Methods From January 2016 to May 2017,2 945 patients with negative cytology of cervix in Tangxia gynecology clinic of Dongguan hospital were selected,and the correlation between the change of vaginal microenvironment and HR-HPV infection was analyzed.Results There were 1 957 cases of vaginal micro environment change in 2 945 cases,accounting for 66.45%.Aerobic vaginitis(AV)accounted for 302 cases(15.43%),bacterial vaginosis(BV)accounted for 578 cases(29.54%),vulvovaginal candidiasis(VVC)accounted for 276 cases(14.10%),trichomonas vaginitis(TV)accounted for 225 cases(11.50%),pure hydrogen peroxide(H_2O_2)deficiency accounted for 246 cases(12.57%)simple,H_2O_2 and white blood cell lipase(LE)was 330 cases(16.86%),mixed vaginitis accounted for 439 cases(22.43%),and HR-HPV infection were 78 cases(25.83%),184 cases(31.86%),83 cases(30.11%),56 cases(24.92%),62 cases(25.24%),94 cases(28.48%),215 cases(48.97%);each group above and the vaginal microenvironment of normal group(normal group)HR-HPV infection rate was statistically significant(P<0.05);BV,VVC and other types of vaginal micro environment change was statistically significant(P<0.05).Differences of infection rates of AV,TV and other types of vaginal micro environment change patients had no statistically significance(P>0.05);mixed vaginitis and HR-HPV infection rate were statistically significance(P<0.05).Conclusion AV,BV,VVC,the TV,H_2O_2,H_2O_2 and simple lack of pure LE positive were correlated with HR-HPV infection.
Objective To investigate the correlation between the change of vaginal microenvironment and high-risk human papillomavirus(HR-HPV)infection.Methods From January 2016 to May 2017,2 945 patients with negative cytology of cervix in Tangxia gynecology clinic of Dongguan hospital were selected,and the correlation between the change of vaginal microenvironment and HR-HPV infection was analyzed.Results There were 1 957 cases of vaginal micro environment change in 2 945 cases,accounting for 66.45%.Aerobic vaginitis(AV)accounted for 302 cases(15.43%),bacterial vaginosis(BV)accounted for 578 cases(29.54%),vulvovaginal candidiasis(VVC)accounted for 276 cases(14.10%),trichomonas vaginitis(TV)accounted for 225 cases(11.50%),pure hydrogen peroxide(H_2O_2)deficiency accounted for 246 cases(12.57%)simple,H_2O_2 and white blood cell lipase(LE)was 330 cases(16.86%),mixed vaginitis accounted for 439 cases(22.43%),and HR-HPV infection were 78 cases(25.83%),184 cases(31.86%),83 cases(30.11%),56 cases(24.92%),62 cases(25.24%),94 cases(28.48%),215 cases(48.97%);each group above and the vaginal microenvironment of normal group(normal group)HR-HPV infection rate was statistically significant(P<0.05);BV,VVC and other types of vaginal micro environment change was statistically significant(P<0.05).Differences of infection rates of AV,TV and other types of vaginal micro environment change patients had no statistically significance(P>0.05);mixed vaginitis and HR-HPV infection rate were statistically significance(P<0.05).Conclusion AV,BV,VVC,the TV,H_2O_2,H_2O_2 and simple lack of pure LE positive were correlated with HR-HPV infection.
引文
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[5]张晓梅,王谨言,王艳华,等.阴道微生态与高危型人乳头瘤病毒感染和宫颈病变的关系研究[J].中国微生态学杂志,2017,29(3):347-350.
[6]李东燕,郝敏.阴道微生态平衡与高危型HPV感染分析[J].中国微生态学杂志,2016,28(5):594-597.
[7]MAYER B T,SRINIVASAN S,FIEDLER T L,et al.Rapid and profound shifts in the vaginal microbiota following antibiotic treatment for bacterial vaginosis[J].J Infect Dis,2015,212(5):793-802.
[8]HAN C,WU W J,FAN A P,et al.Diagnostic and therapeutic advancements for aerobic vaginitis[J].Arch Gynecol Obstet,2015,291(2):251-257.
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[10]唐金芝,高琨,李力.宫颈微环境改变与HPV感染对宫颈癌的影响[J].广西医科大学学报,2013,30(6):971-973.
[11]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.
[12]VIEIRA-BAPTISTA P,LIMA-SILVA J,PINTO C,et al.Bacterial vaginosis,aerobic vaginitis,vaginal inflammation and major Pap smear abnormalities[J].Eur J Clin Microbiol Infect Dis,2016,35(4):657-664.
[13]ABRA N,YAO L Y.Association of genital HPV in fection with other pathogens infection[J].Chin J Gener Pract,2014,6(6):942-944.
[2]FORAN C,BRENNAN A.Prevention and early detection of cervical cancer in the UK[J].Br J Nurs,2015,24(10):22-29.
[3]单玮,张涛,张铁军,等.我国女性人乳头瘤病毒(HPV)感染的流行病学现状[J].中华疾病控制杂志,2017,21(1):89-93.
[4]杨惠霞,郝增平.人乳头瘤病毒与宫颈病变关系的研究进展[J].临床和实验医学杂志,2017,16(3):310-313.
[5]张晓梅,王谨言,王艳华,等.阴道微生态与高危型人乳头瘤病毒感染和宫颈病变的关系研究[J].中国微生态学杂志,2017,29(3):347-350.
[6]李东燕,郝敏.阴道微生态平衡与高危型HPV感染分析[J].中国微生态学杂志,2016,28(5):594-597.
[7]MAYER B T,SRINIVASAN S,FIEDLER T L,et al.Rapid and profound shifts in the vaginal microbiota following antibiotic treatment for bacterial vaginosis[J].J Infect Dis,2015,212(5):793-802.
[8]HAN C,WU W J,FAN A P,et al.Diagnostic and therapeutic advancements for aerobic vaginitis[J].Arch Gynecol Obstet,2015,291(2):251-257.
[9]谈红英,马建婷.阴道微生态改变与宫颈人乳头瘤病毒感染的相关性研究进展[J].中华生殖与避孕杂志,2017,37(5):418-422.
[10]唐金芝,高琨,李力.宫颈微环境改变与HPV感染对宫颈癌的影响[J].广西医科大学学报,2013,30(6):971-973.
[11]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.
[12]VIEIRA-BAPTISTA P,LIMA-SILVA J,PINTO C,et al.Bacterial vaginosis,aerobic vaginitis,vaginal inflammation and major Pap smear abnormalities[J].Eur J Clin Microbiol Infect Dis,2016,35(4):657-664.
[13]ABRA N,YAO L Y.Association of genital HPV in fection with other pathogens infection[J].Chin J Gener Pract,2014,6(6):942-944.