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妇科门诊患者阴道微生态特征与人乳头瘤病毒感染的相关性分析
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Abstract:
目的:探讨妇科门诊患者阴道微生态特征及其与人乳头瘤病毒(HPV)感染的相关性。方法:本次研究选取2024年5月至2024年11月于包头医学院第一附属医院妇科门诊就诊同时行阴道微生态及HPV检查的患者528例,根据其检验结果进行分析。结果:1) 528例患者中,阴道菌群正常者37.9% (200/528),阴道菌群失调者29.3% (155/528),阴道炎32.7% (173/528),以需氧性阴道炎(AV)和外阴阴道假丝酵母菌病(VVC)为主(分别占阴道炎患者的51.0%和24.5%),混合性阴道炎以需氧性阴道炎和合并细菌性阴道病(BV)多见,占阴道炎患者的17.34%。2) 单纯性AV患者与阴道微生态正常患者HPV感染率有显著差异(χ2 = 23.401, P < 0.001),单纯性VVC患者与阴道微生态正常患者HPV感染率有显著差异(χ2 = 7.889, P = 0.005)。3) 在阴道微生态指标中,AV评分异常与HPV感染增加相关(χ2 = 156.819, P < 0.001)。结论:阴道微生态异常与HPV感染有关,阴道微生态特征分析为进一步管理HPV感染患者提供了理论依据。
Objective: To investigate the relationship between vaginal microecology and human papillomAVirus (HPV) infection in gynecological outpatients. Methods: From May 2024 to November 2024, 528 patients who received vaginal microecology and HPV examination in the gynecological outpatient department of the First Affiliated Hospital of Baotou Medical College were selected and analyzed according to their test results. Results: 1) Of 528 patients, vaginal flora was normal in 37.9% (200/528), abnormal in 29.3% (155/528), vaginitis in 32.7% (173/528), mainly aerobic vaginitis (AV) and vulvovaginal candidiasis (VVC) (51.0% and 24.5% of vaginitis patients, respectively). Mixed vaginitis is mainly caused by aerobic vaginitis and bacterial vaginosis (BV), accounting for 17.34% of the patients with vaginitis. 2) There were significant differences in HPV infection rate between patients with simple AV and those with normal vaginal microecology (χ2 = 23.401, P < 0.001), and there were significant differences in HPV infection rate between patients with simple VVC and those with normal vaginal microecology (χ2 = 7.889, P = 0.005). 3) In the vaginal microecological index, the abnormal AV score was associated with the increase of HPV infection (χ2 = 156.819, P < 0.001). Conclusion: Vaginal microecological abnormalities are related to HPV infection, and the analysis of vaginal microecological characteristics provides a theoretical basis for further management of patients with HPV infection.
[1] | Liang, Y., Chen, M., Qin, L., Wan, B. and Wang, H. (2019) A Meta-Analysis of the Relationship between Vaginal Microecology, Human Papillomavirus Infection and Cervical Intraepithelial Neoplasia. Infectious Agents and Cancer, 14, Article No. 29. https://doi.org/10.1186/s13027-019-0243-8 |
[2] | Brusselaers, N., Shrestha, S., van de Wijgert, J. and Verstraelen, H. (2019) Vaginal Dysbiosis and the Risk of Human Papillomavirus and Cervical Cancer: Systematic Review and Meta-Analysis. American Journal of Obstetrics and Gynecology, 221, 9-18.e8. https://doi.org/10.1016/j.ajog.2018.12.011 |
[3] | Huang, R., Liu, Z., Sun, T. and Zhu, L. (2024) Cervicovaginal Microbiome, High-Risk HPV Infection and Cervical Cancer: Mechanisms and Therapeutic Potential. Microbiological Research, 287, Article ID: 127857. https://doi.org/10.1016/j.micres.2024.127857 |
[4] | Yang, A., Farmer, E., Wu, T.C. and Hung, C. (2016) Perspectives for Therapeutic HPV Vaccine Development. Journal of Biomedical Science, 23, Article No. 75. https://doi.org/10.1186/s12929-016-0293-9 |
[5] | Borgdorff, H., Armstrong, S.D., Tytgat, H.L.P., Xia, D., Ndayisaba, G.F., Wastling, J.M., et al. (2016) Unique Insights in the Cervicovaginal Lactobacillus iners and L. crispatus Proteomes and Their Associations with Microbiota Dysbiosis. PLOS ONE, 11, e0150767. https://doi.org/10.1371/journal.pone.0150767 |
[6] | 肖冰冰, 刘朝晖. 阴道微生态评价在阴道炎中的应用[J]. 中国妇产科临床杂志, 2016, 17(6): 483-485. |
[7] | 张岱. 阴道微生态诊断评价的关键问题[J]. 中国实用妇科与产科杂志, 2017, 33(8): 785-787. |
[8] | 陶址, 廖秦平. 阴道微生态的研究进展及临床意义[J]. 实用妇产科杂志, 2018, 34(10): 721-723. |
[9] | Mitra, A., MacIntyre, D.A., Marchesi, J.R., Lee, Y.S., Bennett, P.R. and Kyrgiou, M. (2016) The Vaginal Microbiota, Human Papillomavirus Infection and Cervical Intraepithelial Neoplasia: What Do We Know and Where Are We Going Next? Microbiome, 4, Article No. 58. https://doi.org/10.1186/s40168-016-0203-0 |
[10] | Chehoud, C., Stieh, D.J., Bailey, A.G., Laughlin, A.L., Allen, S.A., McCotter, K.L., et al. (2017) Associations of the Vaginal Microbiota with HIV Infection, Bacterial Vaginosis, and Demographic Factors. AIDS, 31, 895-904. https://doi.org/10.1097/qad.0000000000001421 |
[11] | Yang, J., Wang, W., Wang, Z., Wang, Z., Wang, Y., Wang, J., et al. (2019) Prevalence, Genotype Distribution and Risk Factors of Cervical HPV Infection in Yangqu, China: A Population-Based Survey of 10086 Women. Human Vaccines & Immunotherapeutics, 16, 1645-1652. https://doi.org/10.1080/21645515.2019.1689743 |
[12] | Kovachev, S.M. (2019) Cervical Cancer and Vaginal Microbiota Changes. Archives of Microbiology, 202, 323-327. https://doi.org/10.1007/s00203-019-01747-4 |
[13] | 中华医学会妇产科学分会感染性疾病协作组. 混合性阴道炎诊治专家共识(2021版) [J]. 中华妇产科杂志, 2021(1): 15-18. |
[14] | 伊欣, 张蕾, 陈汶, 等. 高危型人乳头瘤病毒与女性下生殖道感染联合检测专家共识[J]. 中国实用妇科与产科杂志, 2022, 38(5): 524-528. |
[15] | Abbe, C. and Mitchell, C.M. (2023) Bacterial Vaginosis: A Review of Approaches to Treatment and Prevention. Frontiers in Reproductive Health, 5, Article 1100029. https://doi.org/10.3389/frph.2023.1100029 |
[16] | Falconi‐McCahill, A. (2019) Bacterial Vaginosis: A Clinical Update with a Focus on Complementary and Alternative Therapies. Journal of Midwifery & Women’s Health, 64, 578-591. https://doi.org/10.1111/jmwh.13013 |
[17] | Qi, W., Li, H., Wang, C., Li, H., Zhang, B., Dong, M., et al. (2021) Recent Advances in Presentation, Diagnosis and Treatment for Mixed Vaginitis. Frontiers in Cellular and Infection Microbiology, 11, Article 759795. https://doi.org/10.3389/fcimb.2021.759795 |
[18] | 中华医学会妇产科学分会感染性疾病协作组. 阴道微生态评价的临床应用专家共识[J]. 中华妇产科杂志, 2016, 51(10): 721-723. |
[19] | Borgogna, J., Shardell, M., Santori, E., Nelson, T., Rath, J., Glover, E., et al. (2019) The Vaginal Metabolome and Microbiota of Cervical HPV‐Positive and HPV‐Negative Women: A Cross‐Sectional Analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 127, 182-192. https://doi.org/10.1111/1471-0528.15981 |
[20] | Ntuli, L., Mtshali, A., Mzobe, G., Liebenberg, L.J. and Ngcapu, S. (2022) Role of Immunity and Vaginal Microbiome in Clearance and Persistence of Human Papillomavirus Infection. Frontiers in Cellular and Infection Microbiology, 12, Article 927131. https://doi.org/10.3389/fcimb.2022.927131 |
[21] | 吴雄辉, 蓝泽锋, 陆敏茹. 阴道微环境、高危型人乳头瘤病毒感染与宫颈上皮内瘤样病变的关系[J]. 深圳中西医结合杂志, 2021, 31(22): 36-39. |