摘要
目的研究并分析阴道微生态与HR-HPV载量和HPV E6/E7检出率的相关性。方法收集在2017年5月-2019年12月间于我院妇科接受治疗的高危HR-HPV感染患者162例,以病理组织学诊断为依据将其分为3组,并选择同期进行体检的50例正常女性作为正常组,比较各组间阴道微生态失衡率。并通过HR-HPV DNA载量以及HPV E6/E7检出情况将病变患者分为不同亚组,进一步探究不同因素对具体阴道微生态指标的影响。结果阴道失衡率以正常组最低,随着CIN的进展逐渐升高,差异具有统计学意义(P<0.05);进一步分析发现,高HR-HPV DNA载量组与低HR-HPV DNA载量组患者的滴虫、假丝酵母菌等的检出率差异均无统计学意义(P>0.05),但高载量组患者的乳酸杆菌减少、细菌性阴道病等的检出率均明显高于低载量组,差异具有统计学意义(P<0.05);HPV E6/E7阳性组与HPV E6/E7阴性组患者的滴虫、假丝酵母菌等的检出率差异均无统计学意义(P>0.05),但HPV E6/E7阳性组患者的乳酸杆菌减少、细菌性阴道病等的检出率均明显高于HPV E6/E7阴性组,差异具有统计学意义(P<0.05);Spearman分析显示:乳酸杆菌减少及细菌性阴道病与HR-HPV病毒载量及HPV E6/E7均呈显著正相关(P<0.05)。结论阴道微生态失衡与HR-HPV感染后病情进展具有一定相关性,可能通过促进HR-HPV的DNA复制和E6/E7mRNA转录加快CIN的发生发展,其中以阴道乳酸杆菌降低和细菌性阴道病的效应较为明显。
Objective To study and analyze the correlation between vaginal microecology and HR-HPV load and HPV E6/E7detection rate.Methods A total of 162patients with high risk HR-HPV infection treated in our hospital from May 2017to December 2019were divided into 3groups according to histopathological diagnosis,and 50normal women who underwent physical examination in the same period were selected as normal group,and the rate of vaginal microecological imbalance among each group was compared.The patients were divided into different subgroups by HRHPV DNA load and HPV E6/E7detection,and the effects of different factors on specific vaginal microecological indexes were further explored.Results The vaginal imbalance rate was the lowest in the normal group,and increased gradually with the progress of CIN,and the difference was statistically significant.Further analysis showed that there was no significant difference in the detection rates of trichomonas and Candida between the high HR-HPV DNA load group and the low HR-HPV DNA load group,but the detection rates of Lactobacillus and bacterial vaginosis in the high load group were significantly higher than those in the low load group.There was no significant difference in the detection rates of trichomonas and Candida between HPV E6/E7positive group and HPV E6/E7negative group,but the detection rates of lactobacilli and bacterial vaginosis in HPV E6/E7positive group were significantly higher than those in HPV E6/E7negative group.Spearman analysis showed that the decrease of Lactobacillus and bacterial vaginosis were positively correlated with HR-HPV viral load and HPV E6/E7.Conclusion There is a certain correlation between vaginal microecological imbalance and disease progression after HR-HPV infection,which may accelerate the occurrence and development of HR-HPV by promoting DNA replication and E6/E7mRNA transcription of CIN,among which the decrease of Lactobacillus vaginalis and bacterial vaginosis are more obvious.
作者
陈慧峰
潘琦文
李建湘
CHEN Huifeng;PAN Qi-wen;LI Jian-xiang(Department of Gynecology of Hechi people's Hospital,Hechi 547000,China)
出处
《中国实验诊断学》
2020年第9期1449-1453,共5页
Chinese Journal of Laboratory Diagnosis
基金
河池市科学研究与技术开发计划项目(河科B1824-3)。
关键词
阴道微生态
宫颈上皮内瘤变
高危型人乳头瘤病毒
协同作用
Vaginal microecology
cervical intraepithelial neoplasia
high-risk human papillomavirus
synergistic effect
