【摘要】 目的:探索外阴上皮内瘤变(VIN)、宫颈鳞状上皮内病变(SIL)患者阴道微生态的变化,分析持续性高危人乳头瘤病毒(HPV)感染与阴道微生态关系。方法:回顾性收集2018年2月-2020年10月在本院行阴道镜下活检且高危HPV感染患者90例临床资料,根据病理结果分为VIN组30例、SIL组30例、对照组(宫颈活检正常)30例,经治疗后对所有患者随访6个月,根据HPV是否转阴分为HPV持续感染组(27)和HPV转阴组(63例)。所有患者于入组时及随访6个月后行HPV检测,并于入组时行阴道微生态检测,分析不同病变患者阴道微生态差异,分析HPV持续感染及转阴者阴道微生态差异,采用logistics回归分析影响持续性HPV感染的可能因素。结果:VIN组和SIL组滴虫性阴道炎(TV)、细菌性阴道病(BV)及乳酸杆菌减少发生率均高于对照组,随访6个月后持续性HPV感染率VIN组(43.3%)、SIL组(36.7%)、对照组(10.0%)依次降低(P<0.05)。HPV持续感染者TV、BV及乳酸杆菌减少发生率高于HPV转阴者(P<0.05)。BV及乳酸杆菌减少是HPV持续性感染的危险因素(P<0.05)。结论:VIN及SIL患者均存在阴道微生态失衡情况,且持续HPV感染率较高,持续性HPV感染者阴道微生态处于失衡状态,与BV及乳酸杆菌减少有关。更多还原

【Abstract】 Objective: To explore the changes of the vaginal microecology of the women with vulvar intraepithelial neoplasia(VIN) and cervical squamous intraepithelial lesion(SIL), and to analyze the relationship between persistent human papilloma virus(HPV) infection of the women and their vaginal microecology. Methods: The clinical data of 90 women with high risk HP infection who had undergone colposcopy biopsy from February 2018 to October 2020 were collected retrospectively. These women were divided into group A(30 cases with VIN), group B(30 cases with SIL), and group C(30 cases with normal cervical biopsy) according to the results of pathological examination of these women. All these women were followed up for 6 months after treatment, and were further divided into group D(27 cases with persistent HPV infection) and group E(63 cases with HPV negative conversion) according to whether their HPV infection converted to negative. All these women had undergone vaginal microecological examination at the time of enrolling in this study, and the differences of vaginal microecology of the women with different diseases status were analyzed. The differences of the vaginal microecology of the women with persistent HPV infection and the women with HPV negative conversion were analyzed. Logistic regression was used to analyze the possibly factors affecting the persistent HPV infection of the women. Results: The incidences of trichomoniasis vaginitis(TV), bacterial vaginosis(BV) and lactobacillus reduction of the women in group A and group B were significantly higher than those of the women in group C. The persistent infection rate of HPV of the women in group A, in group B, and in group C after 6 months followed up were 43.3%, 36.7%, and 10.0%, respectively, which had decreased gradually(P<0.05). The incidences of TV, BV, and lactobacillus reduction of the women in group D were significantly higher than those of the women in group E(P<0.05).The rate of the BV and lactobacillus decreased of the women were the risk factors of their persistent infection of HPV(P<0.05).Conclusion:The women with VIN and SIL all have vaginal microecological imbalance,and the incidence of their persistent HPV infection is higher.The women with persistent infection of HPV have the vaginal microecological imbalance status,which is association with their BV occurrence and their lactobacillus reduction.更多还原