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高危型HPV阳性宫颈上皮内瘤变(CIN)与阴道微生态指标的相关性研究
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Abstract:
目的：探讨阴道微生态指标与HR-HPV阳性上皮内瘤变(CIN)的相关性。方法：选取HR-HPV阳性且宫颈活检病理提示CIN的215例患者为观察组，病理提示宫颈良性病变的333例患者为对照组。将两组一般情况、阴道微生态指标采用卡方检验或Mann-WhitneyU检验进行单因素分析，将有统计差异的年龄、HPV分型、清洁度、白细胞计数异常率、LE、SNa、NAG、BV进行二元Logistic多因素回归，分析HR-HPV阳性CIN发生的独立危险因素。结果：与年龄 ≤ 25岁相比，年龄在26~45、46~65岁的患者HR-HPV感染均是CIN发生的保护因素[B = ？0.821, OR (95%CI): 0.44 (0.259~0.746), B = ？3.399, OR (95%CI): 0.033 (0.012~0.094)]；与HR-HPV单一型相比，HR-HPV混合型是CIN的危险因素[(B = 0.459, OR (95%CI): 1.583 (1.017~2.464)]；BV(+)、LE(+)是CIN发生的独立危险因素[(B = 4.436, OR (95%CI): 84.457 (8.485~840.682), B = 0.519, OR (95%CI): 1.68 (1.049~2.692)]。结论：阴道微生态与HR-HPV阳性CIN有相关性，阴道微生态失衡可能参与宫颈病变的发生。
Aim: To investigate the correlation between vaginal microecological indicators and HR-HPV-positive intraepithelial neoplasia (CIN). Methods: 215 patients with HR-HPV-positive cervical biopsy indicating CIN were selected as the observation group, and 333 patients with cervical benign lesions were selected as the control group. Chi-square test or Mann-WhitneyU test was used for univariate analysis of the general conditions and vaginal microecological indicators of the two groups, and binary Logistic multivariate regression was performed for age, HPV type, cleanliness, abnormal rate of white blood cell count, LE, SNa, NAG and BV with statistical differences. Independent risk factors for HR-HPV-positive CIN were analyzed. Results: Compared with patients aged ≤ 25 years, HR-HPV infection in patients aged 26~45 and 46~65 years was a protective factor for CIN [B = ？0.821, OR (95%CI): 0.44 (0.259~0.746), B = ？3.399, OR (95%CI): 0.033 (0.012~0.094)]; compared with HR-HPV single type, HR-HPV mixed type was a risk factor for CIN [(B = 0.459, OR (95%CI): 1.583 (1.017~2.464)]. BV(+) and LE(+) were independent risk factors for CIN [(B = 4.436, OR (95%CI): 84.457 (8.485~840.682), B = 0.519, OR (95%CI): 1.68 (1.049~2.692)]. Conclusion: Vaginal microecology is correlated with HR-HPV-positive CIN, and the imbalance of vaginal microecology may be involved in the occurrence of cervical lesions.
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