陶华，韦燕珍，王兴民，周红敏，麦美云

(广西柳州市妇幼保健院妇科，柳州 545001)

血生物指标在宫颈慢性炎症及其病变中的作用分析研究

陶华*，韦燕珍，王兴民，周红敏，麦美云

(广西柳州市妇幼保健院妇科，柳州 545001)

目的通过分析人乳头瘤病毒(HPV)感染患者体内血液相关参数的变化，探讨宫颈上皮病变的有效防治措施和方法。方法收集2016年5月至2016年12月期间在本院门诊确诊的233例高危型HPV感染患者的血常规检查、血清微量元素含量检测及阴道镜病理检测结果等相关资料。根据阴道镜及病理结果将研究对象分为慢性炎症组(单纯HPV感染组)、宫颈上皮病变 CINⅠ组、CINII组、CINIII组和宫颈癌组；HPV阴性者为对照组(233例)，采用方差分析与LSD多重比较法分析不同组间各检测指标的差异。结果(1)6组之间血常规参数中红细胞计数(RBC)、白细胞计数(WBC)的平均水平的差异均无统计学意义(P>0.05)，与对照组对比，慢性炎组的平均血小板体积(MPV)、平均血红蛋白浓度(MCHC)显著下降(P<0.05)，血小板计数(PLT)、血小板压积(PCT)、血细胞平均体积(MCV)显著升高(P<0.05)；CINⅠ组的PLT、PCT显著上升，MPV显著下降(P<0.05)；CINII组、CINIII组的MCHC、MPV显著下降(P<0.05)，PLT、PCT显著上升(P<0.05)；宫颈癌组的MCHC显著下降(P<0.05)，MCV、MPV、PLT、PCT显著上升(P<0.05)；(2)6组之间微量元素中锌(Zn)、镁(Mg)、铜(Cu)的平均水平的差异均无统计学意义(P>0.05)；与对照组对比，慢性炎组的血清钙(Ca)、血清铁(Fe)水平显著降低(P<0.05)；CINⅠ组、CINII组、CINIII组和宫颈癌组的血清铁(Fe)水平均显著降低(P<0.05)。结论HPV感染患者的宫颈上皮内病变程度可能与患者的血常规结果中的MPV、MCV、MCHC、PLT、PCT及血清微量元素中的Fe、Ca含量相关，但需扩大样本量进一步研究。

宫颈病变； HPV感染； 血液检查； 微量元素

Objective： To study the changes of blood biochemical index in the patients infected by human papillomavirus(HPV)for obtaining scientific evidences in support of prevention and treatment for cervical inflammation and lesions.

Methods： The data including the results of blood routine examination，serum trace element content detection and colposcopic pathology of 233 patients diagnosed with high-risk HPV infection in the Liuzhou Maternity and Child Health Care Hospital from May to December 2016 were collected.According to colposcopy and pathological results，the patients were divided into five groups：chronic inflammatory(HPV infection alone)，CINI，CINII，CINIII，and cervical cancer group.Meanwhile，233 patients with negative HPV test were included as the control group.The variance analysis and LSD multiple comparison were used to analyze the differences among the different groups.

Results： The differences in various blood parameters including RBC and WBC were not significantly differnt among the six groups(P>0.05).Compared with control group，the mean platelet volume(MPV)and mean hemoglobin concentration(MCHC)were significantly decreased(P<0.05)，but the platelet count(PLT)，platelet count(PCT)and blood cell mean volume(MCV)were significantly increased in the chronic inflammatory group(P<0.05).The PLT and PCT were significantly increased，but MPV was significantly decreased in CINⅠ group(P<0.05).The MCHC and MPV were significantly decreased，but PLT & PCT were significantly increased in CINII and CINIII group(P<0.05).The levels of MCV，MPV，PLT and PCT were significantly increased，but the MCHC was significantly decreased in the cervical cancer group(P<0.05).There were no significant differences in the average levels of Zn，Mg and Cu among the six groups(P>0.05).Compared with the control group，the levels of serum calcium(Ca)and iron(Fe)were significantly decreased in chronic inflammation group(P<0.05).The levels of serum Fe were significantly decreased in CINⅠ，CINII，CINIII group and cervical cancer group(P<0.05).

Conclusions： The degree of cervical intraepithelial lesion may be related to MPV，MCV，MCHC，PLT，PCT and serum trace elements in patients with HPV infection，but need to further expand the sample size of study.

Keywords： Cervical lesions； HPV infection； Blood routine examination； Trace elements

(JReprodMed2017，26(10)：1006-1010)

宫颈上皮病变(CIN)是已婚女性常见的一种疾病，子宫颈癌在女性恶性肿瘤中排第二位，仅次于乳腺癌，女性生殖系统恶性肿瘤中占第一位。全世界每年超过20万的妇女死于宫颈癌[1]，其中主要原因是缺乏病因学的预防及早诊早治方案。因此，研究宫颈癌早期病变时期机体相关因素的变化其发病的危险因素，对于宫颈癌的预防及治疗十分重要。

在1995年，由IARC专题讨论会确认了HPV感染是子宫颈癌的主要病因。德国……