邱雁 潘敏

【摘要】 目的：研究高危型人乳头瘤病毒（HR-HPV）持续感染患者阴道菌群与子宫颈局部免疫功能改变的关系。方法：选择2020年1月-2021年1月来本院进行HPV检查的145例女性为研究对象，其中HR-HPV阳性患者90例为研究组，55例HR-HPV阴性者为对照组。观察研究组患者感染情况，以及阴道微生态失调、菌群阳性率、T淋巴细胞亚群分布。结果：HPV感染的患者中以单一型感染为主，主要为HPV16（38.89%），复合型感染占比较少。研究组阴道微生态失调51.11%高于对照组的21.82%，乳酸杆菌异常、细菌性阴道炎、衣原体、滴虫、解脲脲原体阳性率均高于对照组，差异均有统计学意义（P<0.05）。研究组CD8+高于对照组，CD3+、CD4+均低于对照组，差异均有统计学意义（P<0.05）。结论：HR-HPV感染患者，更容易出现阴道微生态失调，阴道菌群会发生变化，子宫颈免疫功能也会下降。

【关键词】 高危型 人乳头瘤病毒 感染 阴道菌群 免疫功能

Relation Studies of Vaginal Microbiota and Cervical Local Immunity in Persistent High-risk Human Papillomavirus Infection Patients/QIU Yan， PAN Min. //Medical Innovation of China， 2021， 18（14）： -137

[Abstract] Objective： To study the relationship between the vaginal microflora and the changes of local cervical immune function in patients with persistent high-risk human papillomavirus （HR-HPV） infection. Method： A total of 145 women who came to our hospital for HPV examination from January 2020 to January 2021 were selected as the study subjects， among which 90 patients with HR-HPV positive were included in the study group and 55 patients with HR-HPV negative were included in the control group. Infection， vaginal microdysregulation， positive rate of bacteria and distribution of T lymphocyte subsets were observed in the study group. Result： The majority of HPV infected patients were single type infection， mainly HPV16 （38.89%）， complex type infection accounted for less. The positive rates of Lactobacillus abnormality， bacterial vaginitis， Chlamydia， Trichomonas and Ureaplasma ureticum in the study group were all higher than those in the control group， the differences were statistically significant （P<0.05）. CD8+ in the study group was higher than that in the control group， while CD3+ and CD4+ were lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Patients with HR-HPV infection are more likely to have vaginal microdysbiosis， changes in the vaginal microflora， and decreased cervical immune function.

[Key words] High-risk Human papillomavirus Infection Vaginal microbiota Immunity

First-authors address： Maoming Peoples Hospital， Maoming 525000， China

doi：10.3969/j.issn.1674-4985.2021.14.032

子宮颈癌已经纳入了全球最为常见的恶性肿瘤，临床发病率较高，呈逐年上升趋势[1]。由于女性阴道是由自身的免疫系统、菌群组成，在控制炎症与抵挡病原菌中起到了关键作用[2]。国内外研究证实，人乳头瘤病毒（HPV）感染与子宫颈癌存在密切关系，也是发生的必要条件，在感染HPV后，超过8%的患者会发展为子宫颈癌及其相关病变[3]。目前主要以高危型人乳头瘤病毒（HR-HPV）感染为主，感染后患者会出现局部免疫功能障碍，阴道菌群失调的情况，诱发病变[4]。本文通过分析HR-HPV患者阴道菌群与局部免疫功能改变的关系，现报道如下。

1 资料与方法

1.1 一般资料 选择2020年1月-2021年1月来本院进行HPV检查的145例女性为研究对象。（1）纳入标准：①可以进行TCT检测、阴道镜活检、HPV-DNA检测;②有性生活、月经规律。（2）排除标准：①存在全身性感染疾病;②既往有子宫颈手术史。……