甘维梅 彭婧

【摘要】 目的：探討高危型人乳头瘤病毒（HPV）感染患者阴道微生态特征及其相关性。方法：回顾性分析2018年1月-2020年11月在本院同时实施HPV与阴道微生态检测的3 267例患者的临床资料，分析阴道微生态特征与高危型HPV感染情况以及两者间的关系。结果：3 267例患者经检查存在微生态异常1 004例（30.73%），其中BV感染327例、需氧菌性阴道炎（AV）感染156例、外阴阴道假丝酵母菌病（VVC）342例、滴虫性阴道炎（TV）148例、混合性感染31例。高危型HPV感染350例，其中HPV 16型最为常见，占26.29%。AV感染者高危型HPV感染率高于非AV感染者，BV感染者高危型HPV感染率高于非BV感染者，差异均有统计学意义（P<0.05）;AV、BV感染与高危型HPV感染密切相关（P<0.05）。VVC感染者与非VVC感染者、TV感染者与非TV感染者高危型HPV感染率比较，差异均无统计学意义（P>0.05）。结论：AV、BV感染会增加高危型HPV感染发生率，临床需加以重视，及时采取防治措施。

【关键词】 高危型人乳头瘤病毒 细菌性阴道病 阴道微生态特征

Vaginal Microecological Characteristics and Its Correlation in High-risk HPV Infection Patients/GAN Weimei， PENG Jing. //Medical Innovation of China， 2021， 18（12）： -178

[Abstract] Objective： To investigate the vaginal microecological characteristics and its correlation of high-risk human papillomavirus （HPV） infection patients. Method： Retrospective analysis was performed on the clinical data of 3 267 patients who received both HPV and vaginal microecological detection in our hospital from January 2018 to November 2020， and the relationship between vaginal microecological characteristics and high-risk HPV infection was analyzed. Result： Among 3 267 patients， 1 004 cases （30.73%） had microecological abnormalities， including 327 cases of BV infection， 156 cases of aerobic vaginitis （AV） infection， 342 cases of vulvovaginal candidiasis （VVC）， 148 cases of trichomonad vaginitis （TV） and 31 cases of mixed infection. There were 350 cases of high-risk HPV infection， among which HPV 16 was the most common， accounting for 26.29%. The infection rate of high-risk HPV in AV patients was higher than that in non-AV patients， and the infection rate of high-risk HPV in BV patients was higher than that in non-BV patients， the differences were statistically significant （P<0.05）. AV and BV infection were closely related to high-risk HPV infection （P<0.05）. There were no significant differences in the infection rate of high-risk HPV between VVC-infected and non-VVC-infected persons， or between TV-infected and non-TV-infected persons （P>0.05）. Conclusion： AV and BV infection will increase the incidence of high-risk HPV infection， clinical attention should be paid to it， and timely preventive measures should be taken.

[Key words] High-risk human papillomavirus Bacterial vaginosis Vaginal microecological characteristics

First-authors address： Hongdu Hospital of Traditional Chinese Medicine， Nanchang 330008， China

doi：10.3969/j.issn.1674-4985.2021.12.042

子宫颈癌属于生殖系统恶性肿瘤，其发生与同一高危型人乳头瘤病毒（HPV）持续感染密切相关[1-2]。调查显示，女性一生中HPV感染率累积高达70%～80%，并非所有的高危型HPV感染均可进展为子宫颈癌或高级别宫颈上皮内瘤变（CIN）[3-4]。约有90%的高危型HPV感染可在2年内被机体自身免疫力清除，其余10%可发展为持续感染，有1%持续感染者可进展为子宫颈癌或高级别CIN。研究显示，除机体免疫状态外，高危型HPV感染与阴道局部微生态环境存在密切关系[5]。本研究旨在探讨高危型HPV感染患者阴道微生态特征及其相关性，为临床治疗提供新的思路。现报道如下。

1 资料与方法

1.1 一般资料 回顾性分析2018年1月-2020年11月在本院同时实施HPV与阴道微生态检测的3 267例患者的临床资料，年龄20～65岁，平均（36.65±3.14）岁。……