绝经后人乳头瘤病毒感染的宫颈鳞状上皮内病变与阴道微生态的关系

目的 探讨绝经后人乳头瘤病毒(human papilloma virus, HPV)感染的宫颈鳞状上皮内病变(cervical squamous intraepithelial lesion, SIL)与阴道微生态变化的相关性,进而为调节阴道微生态平衡,阻断绝经后HPV感染的SIL发生发展提供依据。方法 收集2018年4月至2019年4月在保定市第一中心医院妇科门诊就诊的绝经后女性相关情况,HPV阳性伴或不伴薄层液基细胞学检查(thinprep cytologic test, TCT)异常,进一步行阴道镜下宫颈活组织检查,诊断为SIL的122例患者作为病变组,无SIL的129例患者作为正常组。比较2组阴道微生态的检查结果。结果 病变组和正常组细菌性阴道病(bacterial vaginosis, BV)检出率分别为32.79%和12.40%(P<0.001);外阴阴道假丝酵母菌病(vulvovaginal candidiasis, VVC)分别为14.75%和10.85%(P>0.050);阴道清洁度III~IV度分别为68.03%和46.51%(P<0.050);乳酸杆菌少分别为13.93%和20.16%(P>0.050); WBC计数>10个/高倍镜下(highest possible frequency, HPF)分别为62.30%和40.31%(P<0.001);过氧化氢(H₂O₂)缺乏分别为15.57%和22.48%(P>0.050);白细胞酯酶阳性分别为36.07%和17.83%(P<0.050);唾液酸苷酶阳性分别为19.67%和6.20%(P<0.050)。结论 BV、阴道清洁度差、WBC多、白细胞酯酶及唾液酸苷酶阳性可能与绝经后HPV感染的SIL的发生发展密切相关。

Relationship between cervical squamous intraepithelial lesions and vaginal microecology in postmenopa-usal women with human papilloma virus infection

Objective To investigate the correlation between cervical squamous intraepithelial lesions(SIL)and vaginal microecological changes in postmenopausal women with human papilloma virus(HPV)infection, and to regulate vaginal microecological balance and block postmenopausal women with HPV infection provide evidence for the development of SIL. Methods We collected postmenopausal women who attended the gynecological clinic of Baoding First Central Hospital from April 2018 to April 2019. HPV positive with or without thinprep cytologic test(TCT)was abnormal. Further colposcopy of cervical biopsy was performed, and 122 patients with SIL were diagnosed as the disease group, and 129 patients without SIL were regarded as the normal group. The results of vaginal microecology examination were compared between the two groups. Results The detection rates of bacterial vaginosis(BV)in the disease group and normal group were 32.79% and 12.40%, respectively(P<0.001). Vulvovaginal candidiasis(VVC)were 14.75% and 10.85%, respectively(P>0.050). Vaginal cleanliness III-IV degrees were 68.03% and 46.51%, respectively(P<0.050). A small amounts of lactobacillus were 13.93% and 20.16%, respectively(P>0.050). WBC>10/HPF were 62.30% and 40.31%, respectively(P<0.001). H₂O₂ deficiency were 15.57% and 22.48%, respectively(P>0.050). Leukocyte esterase positive were 36.07% and 17.83%, respectively(P<0.050). Sialidase positive were 19.67% and 6.20%, respectively(P<0.050). Conclusion BV, poor vaginal cleanliness, more white blood cells, leukocyte esterase and sialidase positive may be closely related to the occurrence and development of SIL in postmenopausal women with HPV infection.