阴道微生态与高危型人乳头瘤病毒感染和宫颈病变的相关性分析

目的探讨阴道微生态状况与高危型人乳头瘤病毒(human papilloma virus,HPV)感染和宫颈病变之间的关系。方法选取2014年4月至2015年5月在华北理工大学附属医院妇科门诊就诊的311例妇女为研究对象,对其进行阴道微生态(五联酶法)、宫颈液基细胞学(TCT)及高危型HPV检测(HRHPV)。将其中84例HPV阳性者、77例宫颈病变者作为研究组,与227例HPV阴性者及234例宫颈正常者进行对比,分析其阴道微生态状况。结果乳酸杆菌少或无者感染HPV及发生宫颈病变的可能性明显高于乳酸杆菌中量者;阴道清洁度3~4度者感染HPV及发生宫颈病变的可能性明显高于清洁度1~2度者;阴道有念珠菌感染者感染HPV及发生宫颈病变的可能性明显高于无念珠菌感染者,差异均有统计学意义(P0.05)。结论乳酸杆菌是维持阴道微生态正常的保护性因素,而阴道清洁度差及有念珠菌感染可能增加感染HPV及发生宫颈病变的可能性。

Analysis of correlation between vaginal micro -ecology,high risk HPV infection and cervical lesions

Objective To investigate the relationship between vaginal micro -ecology status , high risk human papillomavirus ( HR -HPV ) infection and cervical lesions .Method 311 women were selected as the research object in the Department of Gynecology clinic of North China University of science and Engineering Affiliated Hospital from April 2014 to May 2015, detected their vaginal micro -ecology ( quintuplet enzyme method ) , liquid based cervical cytology ( TCT ) and high risk HPV ( HR -HPV ) infection.84 cases of HPV positive, 77 cases of cervical lesions were selected as the research group , 227 cases of HPV negative and 234 cases of normal cervical were selected as the control group , compared vaginal micro -ecology of two groups .Results The cases with little or no lactobacillus had more possibility of infection of HPV and occurrence of cervical lesions than the cases with amounts of lactobacillus;the cases with 3 or 4 degrees of vagina cleaness had more possibility of infection of HPV and occurrence of cervical lesions than the cases of 1 or 2 degrees of vagina cleaness;the cases with vaginal candida infection had more possibility of infection of HPV and occurrence of cervical lesions than the cases without vaginal candida infection .The differences were statistically significant (P<0.05).Conclusion Lactobacillus is a protective factor of maintaining the normal vagina micro -ecology, and poor vaginal cleanliness and candida infection may increase the possibility of infection of HPV and the occurrence of cervical lesions .