臭氧治疗对宫颈病变及人乳头瘤病毒感染患者局部组织及外周血中T淋巴细胞表达的影响

目的 观察臭氧治疗对宫颈上皮内瘤变（CIN）Ⅰ级、高危人乳头瘤病毒（HPV）感染患者全身及局部T淋巴细胞的影响,探讨其治疗效果.方法 将144例CIN Ⅰ级、高危HPV感染的患者按HPVDNA载量分为3组：高载量组（＞1000 RLU/CO）67例,中载量组（500 ～1000 RLU/CO） 45例,低载量组（＜ 500 RLU/CO） 32例,采用流式细胞术及免疫组织化学SP法检测与慢性宫颈炎对照组静脉血CD4＋、CD8＋、CD4＋/CD8＋比值变化及宫颈组织中CD4＋、CD8＋的变化,并对CIN Ⅰ级、高危HPV感染的患者于臭氧治疗后进行检测,并追踪1、3、6、9、12个月.结果 CIN Ⅰ级、高危HPV感染的患者外周血CD4＋下降、CD8＋增高,CD4＋/CD8＋下降,CIN Ⅰ组与对照组间差异无统计学意义（P＞0.05）;局部组织中CD4＋、CD8＋低表达,在CIN Ⅰ组与对照组间差异有统计学意义（p＜0.05）;对照组和CIN Ⅰ组经臭氧治疗后与治疗前比较,CD4＋增高[对照组：35.8±1.2比34.7±1.2,CIN Ⅰ组：36.7 ±0.5比36.6±0.6] 、CD8＋下降[对照组：23.1 ±1.2比24.1 ±1.1,CIN Ⅰ组：22.7±1.1比23.2±1.0],CD4＋/CD8＋上升,而治疗后与对照组比较,差异无统计学意义（P＞0.05）.臭氧治疗后1周与治疗前比较,对照组、CIN Ⅰ组宫颈组织CD4＋和CD8＋表达的阳性增高[对照组：57.6％ （83/144）比46.7％ （67/144）,56.9％（82/144）比50.0％ （72/144）,CIN Ⅰ组：75.0％ （108/144）比63.3％（91/144）,63.9％（92/144）比53.3％（77/144）],差异有统计学意义（P＜0.05）;治疗后与对照组比较,CIN Ⅰ组患者宫颈组织CD4＋和CD8＋表达的阳性明显增高,差异有统计学意义（P＜0.01）.臭氧治疗宫颈上皮内瘤变Ⅰ级、高危HPV感染患者1个月后高载量组、中载量组、低载量组的有效率分别为82.0％（55/67） 、84.4％（38/45）、90.6％（29/32）,各组间有效率差异无统计学意义（P＞0.05）,总有效率为84.7％.结论 臭氧治疗通过改善宫?

Study on the expression of T lymphocyte cell of cervical intraepithelial neoplasiaI and high risk human papilloma virus infection in localized tissue and peripheral blood during ozone therapy

Objective To explore the effect of ozone therapy on cervical intraepithelial neoplasia （CIN Ⅰ） and high risk human papilloma virus（HR-HPV） infection with the changes of T lymphocyte cell in peripheral blood and in local tissue.Methods Totally 144 patients with CINⅠ） and HR-HPV infection were divided into high viral load （〉1000 RLU/CO,67 cases）,moderate viral load （500-1000 RLU/CO,45 cases） and low viral load （〈500 RLU/CO,32 cases）.Flow cytometry and immunohistochemistry S-P method were used to determine CD4 ＋,CD8 ＋,CD4 ＋/CD8 ＋ ratio change in CIN Ⅰ,HR-HPV and control group patients.Before and after ozone treatment,patients were followed up for one,three,six,nine and twelve months.Results CD4 ＋ reduced,CD8 ＋ increased and CD4 ＋/CD8 ＋ ratio of peripheral blood decreased in CIN Iand HPV patients ; there was no significant difference （P 〉 0.05） between CIN Ⅰ group and control group; low expression of CD4 ＋,CD8 ＋ developed in local tissue.There was significant difference（P 〈 0.05） between CINⅠgroup and normal control group; CD4 ＋ increased [control group：35.8 ± 1.2 vs 34.7 ± 1.2,CINⅠ group：36.7 ± 0.5 vs 36.6 ± 0.6],CD8＋ decreased [control group：23.1 ± 1.2 vs 24.1 ± 1.1,CINⅠ group：22.7 ± 1.1 vs 23.2 ± 1.0] and CD4 ＋/CD8 ＋ ratio increased,after ozone therapy in both CIN Ⅰ group and control group.1 week after ozone treatment,compared with those before treatment,positive expression of CD4 ＋ and CD8 ＋ of cervical tissue between control group and CIN Ⅰ group increased [control group：57.6% （83/144）,46.7% （67/144）,56.9% （82/144）,50.0% （72/144）,CIN Ⅰ group：75.0% （108/144）,63.3% （91/144）,63.9% （92/144）,53.3% （77/144）],the difference was statistically significant （P 〈 0.05）.After treatment,the rate of cervical tissue expression positive CD4 ＋ and CD8 ＋ increased more in CIN Ⅰ group than that in control group; the difference was statistically significant （P 〈 0.01）.The eff