高级别鳞状上皮内病变患者治疗后1年阴道微生态与HPV转归的相关性分析

doi:10.3969/j.issn.1671-7171.2019.11.021

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摘要 【目的】探讨高级别鳞状上皮内病变(HSIL)患者治疗后1年阴道微生态与HPV转归的相关性。【方法】回顾性分析2013年1月至2017年9月在本院诊治的96例HSIL患者的临床资料,根据治疗后1年HPV是否转阴分为HPV持续感染组(50例)和HPV转阴组(46例)。比较两组治疗后1年的基本情况、阴道菌群密集度、阴道菌群多样性、阴道菌群性质。【结果】两组治疗后1年的年龄、慢性疾病比较差异均无统计学意义(P>0.05);HPV持续感染组的表层鳞状细胞、妇科疾病显著高于HPV转阴组,差异有统计学意义(P<0.05);HPV持续感染组阴道菌群密集度、菌群多样性、菌群性质的异常率均显著高于HPV转阴组,其差异均有统计学意义(P<0.05)。多因素logistic回归分析显示:阴道菌群多样性和阴道菌群性质是HPV转归的独立危险因素(P<0.05)。【结论】阴道微生态的平衡是HPV转归的关键,临床可根据阴道菌群多样性及优势菌数量等对患者进行针对性治疗,以控制HSIL的发生发展,降低宫颈癌几率。

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	王娟

关键词 ：阴道/微生物学, 乳头状瘤病毒科

Abstract：【Objective】To investigate the relationship between the vaginal microecological one-year therapy and the outcome of HPV in patients with high grade squamous intraepithelial lesions (HSIL). 【Methods】The clinical data of 96 cases of HSIL treated in our hospital from January 2013 to September 2017 were analyzed retrospectively. According to whether HPV turned negative in one year after treatment, they were divided into HPV persistent infection group (50 cases) and HPV turned negative group (46 cases). One year after treatment, the basic situation, the density of vaginal flora, the diversity of vaginal flora and the nature of vaginal flora were compared between the two groups. 【Results】There was no significant difference in age and chronic diseases between the two groups (P>0.05); the surface squamous cells and gynecological diseases in the HPV persistent infection group were significantly higher than those in the HPV transvaginal group (P<0.05); the abnormal rates of vaginal flora density, flora diversity and flora property in the HPV persistent infection group were significantly higher than those in the HPV transvaginal group (P<0.05). Multivariate logistic regression analysis showed that the diversity of vaginal flora and the nature of vaginal flora were independent risk factors for HPV outcome (P<0.05). 【Conclusion】The balance of vagina microecology is the key to the prognosis of HPV. In order to control the occurrence and development of HSIL and reduce the risk of cervical cancer, targeted treatment can be carried out according to the diversity of vagina flora and the number of dominant bacteria.

Key words： Vagina/MI Papillomaviridae

收稿日期: 2018-10-14

PACS:

R339.224

引用本文:

王娟. 高级别鳞状上皮内病变患者治疗后1年阴道微生态与HPV转归的相关性分析[J]. 医学临床研究, 2019, 36(11): 2148-2150.
WANG Juan. Analysis of the Relationship between One-year Vaginal Microecological Treatment and HPV Outcome in Patients with High-grade Squamous Intraepithelial Lesions. JOURNAL OF CLINICAL RESEARCH, 2019, 36(11): 2148-2150.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2019.11.021 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2019/V36/I11/2148