【摘要】 目的:探讨宫颈锥切术联合三元融合蛋白(MBP-SERPINA-IFNκ,MSIK)治疗宫颈高级别鳞状上皮内病变(high-grade cervical lesions, HSIL)合并高危型人乳头瘤病毒(high-risk human papillomavirus, HR-HPV)感染的临床效果。方法:选取2019年08月至2021年07月我院收治的186例HSIL患者，采用随机数字表法分为MSIK组(n=93)和对照组(n=93),两组均接受宫颈锥切术治疗，对照组术后非经期阴道推入干扰素α-2β凝胶，隔日一次，10次/疗程，MSIK组术后非经期阴道推入MSIK,14 d/疗程，均治疗3个疗程。比较两组患者治疗前后不同时间点TCT异常率及HR-HPV转阴率，比较两组治疗前后临床症状评分改变、治疗期间不良反应，比较两组治愈率及复发率。结果:随访期间两组HR-HPV转阴率呈升高趋势，且随访9、12个月两组HR-HPV转阴率均较随访3个月时升高(P<0.05);随访3、6、9、12个月时，MSIK组HR-HPV转阴率均高于对照组(P<0.05)。随访3、6、9、12个月，两组TCT异常率均明显低于治疗前，且MSIK组低于对照组(P<0.05)。治疗后两组临床症状评分较治疗前降低，且MSIK组更低(P<0.05)。MSIK治疗期间不良反应发生率为3.23%,低于对照组的10.75%(P<0.05)。MSIK组治愈率为97.85%,高于对照组的81.72%(P<0.05);随访12个月MSIK组无复发情况，与对照组复发率比较差异有统计学意义(P<0.05)。结论:宫颈锥切术联合MSIK治疗HSIL合并HR-HPV感染可有效提高转阴率，且治疗效果确切、复发率低，值得临床推广。更多还原

【Abstract】 Objective:To investigate the clinical effect of cervical conization combined with ternary fusion protein(MSIK) in the treatment of high-grade cervical lesions(HSIL) complicated with high-risk human papillomavirus(HR-HPV) infection.Methods:A total of 186 patients with HSIL admitted to our hospital from August 2019 to July2021 were selected and randomly divided into MSIK group(n=93) and control group(n=93) by the odd-even method.Both groups were treated with cervical conization.In the control group,human interferon α-2β non-menstrual vaginal effervescent capsule,once every other day,10 times/course,and 3 courses were shared.In MSIK group,non-menstrual vaginal insertion of MSIK was performed for 14 days/course,a total of 3 course.HR-HPV negative conversion rate and TCT abnormality rate were compared between the two groups at different time points before and after treatment.The changes of clinical symptom score before and after treatment and adverse reactions during treatment were compared between the two groups.The cure rate and recurrence rate were compared between the two groups.Results:The negative conversion rate of HR-HPV in the two groups increased during the follow-up period,and the negative conversion rate of HR-HPV in the two groups at 9 and 12 months of follow-up was higher than that at3 months of follow-up(P <0.05).The negative conversion rate of HR-HPV in MSIK group was higher than that in control group at 3,6,9,and 12 months of follow-up(P <0.05).After 3,6,9 and 12 months of followup,HR-HPV TCT abnormality rate in the two groups was significantly lower than that before treatment,and that in the MSIK group was lower than that in the control group(P <0.05).After treatment,the clinical symptom scores of the two groups were lower than those before treatment,and the MSIK group was lower than that before treatment(P <0.05).The incidence of adverse reactions during MSIK treatment was 3.23%,which was lower than10.75% in the control group(P <0.05).The cure rate of MSIK group was 97.85%,which was higher than81.72% of control group(P <0.05).After 12 months of follow-up,there was no recurrence in the MSIK group,and the recurrence rate was significantly different from that in the control group(P <0.05).Conclusion Cervical conization combined with MSIK in the treatment of HSIL complicated with HR-HPV infection can effectively reduce the viral load of HR-HPV,improve the negative conversion rate,and the treatment effect is exact,the recurrence rate is low,the clinical acceptance is worthy of clinical promotion.更多还原