宫颈上皮内瘤变患者HPV感染与阴道微生态关系研究

发布时间：2018-04-29 11:14

本文选题：宫颈上皮内瘤变 + HPV感染　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的:通过分析高危型HPV感染的宫颈上皮内瘤变(CIN)患者的阴道微生态状况及LEEP术后HPV持续阳性与阴道微生态状况的关系,为CIN患者治疗中恢复阴道微生态提供依据。方法:回顾2014年1月至2016年12月在我院宫颈病变中心进行LEEP术的CIN患者治疗前后阴道微生态状况及术后HPV感染情况。结果:1542例患者中具有完整随访资料者845例,其中81.5%(711/845)的患者阴道微生态异常,37.2%(314/845)的患者检测出明确致病菌,以细菌性阴道病(BV)为主,明显高于其它阴道炎(P0.05)。接受LEEP术后,233例患者HPV持续阳性,其中80.7%(188/233)患者阴道微生态异常,BV和VVC的感染率分别为37.3%(87/233)和6.9%(16/233);612例患者HPV转阴,其中14.4%(88/612)患者微生态异常,BV及VVC的感染率分别为6%(37/612)和1.3%(8/612),与术后HPV持续阳性患者相比,其阴道微生态异常率及BV、VVC的感染率明显下降(P0.05)。结论:合并高危型HPV感染的CIN患者阴道微生态异常较为普遍,其中以BV感染最为常见,CIN患者LEEP术后HPV持续阳性与阴道微生态异常相关,尤其是BV、VVC感染引起的阴道炎有关,提示清除致病菌、治疗阴道炎、恢复阴道微生态在CIN治疗及促使HPV转阴中十分重要。
[Abstract]:Objective: to analyze the relationship between vaginal microecology and vaginal microecology in patients with high risk HPV infection of cervical intraepithelial neoplasia (cin), and to provide evidence for the recovery of vaginal microecology during the treatment of CIN patients. Methods: from January 2014 to December 2016, the vaginal microecology and postoperative HPV infection of CIN patients undergoing LEEP in our cervical lesion center were reviewed. Results there were 845 cases with complete follow-up data in 1 542 cases, among which 81.5% (711% 845) patients with abnormal vaginal microecology (37.214% 845) were found to have definite pathogenic bacteria, mainly bacterial vaginosis (BV), which was significantly higher than that of other vaginitis (P 0.05). The positive rates of HPV and VVC were 37.387 / 233and 6.910 / 233respectively in 80.7% / 188 / 233 (80.7% / 233) patients after LEEP, respectively. HPV turned negative in 612 cases. The infection rates of BV and VVC in patients with microecological abnormality were 637 / 612) and 1.38 / 612g respectively. Compared with the patients with persistent positive HPV after operation, the rate of abnormal vaginal microecology and the infection rate of VVC decreased significantly (P 0.05). Conclusion: vaginal microecological abnormalities are common in CIN patients with high risk HPV infection. Among them, the persistent positive HPV after LEEP in patients with BV infection is associated with vaginal microecological abnormalities, especially vaginitis caused by LEEP infection. It was suggested that eliminating pathogenic bacteria, treating vaginitis and restoring vaginal microecology were very important in the treatment of CIN and promoting HPV to turn negative.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33

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