首页|宫颈高度鳞状上皮内病变术后高危型人乳头瘤病毒持续感染型别及危险因素

宫颈高度鳞状上皮内病变术后高危型人乳头瘤病毒持续感染型别及危险因素

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目的 探讨宫颈高度鳞状上皮内病变(HSIL)患者术后高危型人乳头瘤病毒(HR-HPV)持续感染型别及危险因素.方法 回顾性收集2020年1月-2022年3月华中科技大学同济医学院附属武汉儿童医院收治的108例HSIL且宫颈锥切术后随访至少半年明确HR-HPV持续感染者及83例术后HPV阴性者的临床资料,分别为感染组、对照组,分析感染组感染型别,分析HSIL患者术后HR-HPV持续感染的危险因素,同时进行阴道菌群检测,明确微生态环境的改变情况.结果 感染组中,HSIL患者术后HR-HPV持续感染中以HPV16、18、58型别为主;单因素及Logistic回归分析发现年龄≥40岁、病变点数≥3、术前HR-HPV负荷≥500 RLU/CO、锥切标本厚度≤1 cm为HSIL患者术后HR-HPV持续感染的危险因素(P＜0.05).感染组中,乳酸杆菌＜70％、pH＞4.5、细菌性阴道病检出率高于对照组(P＜0.05).结论 HSIL患者术后HR-HPV持续感染以单一感染为主,感染型别主要为HPV16,且会受到年龄、病变点数、术前HR-HPV负荷、锥切标本厚度的影响,同时术后HR-HPV持续感染会影响阴道微生态环境,增加微生物感染风险.
Subtypes and risk factors for postoperative persistent high-risk human papillomavirus infection in patients with high-grade squamous intraepithelial lesion
OBJECTIVE To explore the subtypes and risk factors for the postoperative persistent high-risk human papillomavirus(HR-HPV)infection in the patients with high-grade squamous intraepithelial lesion(HSIL).METHODS The clinical data were retrospectively collected from 108 patients with HSIL who underwent cervical conization in Wuhan Children's Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology and were diagnosed with persistent HR-HPV infection through at least 6months of follow-up,and the clinical data were also retrospectively collected from 83 patients who were negative for postoperative HPV.The enrolled patients were divided into the infection group and the control group,respectively.The subtypes of HPV infection were analyzed,the risk factors for the postoperative persistent HR-HPV infection were analyzed,the va-ginal flora were detected,and the change of the microecological environment was identified.RESULTS The HPV16,HPV18 and HPV58 were the predominant subtypes of postoperative persistent HR-HPV infection a-mong the HSIL patients in the infection group.The result of univariate analysis and logistic regression analysis showed that the no less than 40 years of age,no less than 3 of lesion sites,preoperative HR-HPV load no less than 500 RLU/CO and thickness of specimens removed by conization no more than 1 cm were the risk factors for the postoperative persistent HR-HPV infection in the HSIL patients(P＜0.05).The detection rates of Lactobacil-lus less than 70％,pH more than 4.5 and bacterial vaginosis were higher in the infection group than in the control group(P＜0.05).CONCLUSION The single subtype of postoperative HR-HPV infection is dominant among the HSIL patients,the HPV16 is the predominant subtype and is affected by the age,number of lesion sites,preoper-ative HR-HPV load and thickness of specimens removed by conization.The postoperative persistent HR-HPV in-fection may affect the vaginal microecological environment and increase the risk of microbial infection.

High-grade squamous intraepithelial lesionHigh-risk human papillomavirusCervical conizationPersistent infectionSubtype of infectionRisk factorVaginal microecological environment

肖婷婷、吴美琴、范丽、雷凤琼、叶晶晶

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华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)手术室,湖北武汉 430000

华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)妇科,湖北武汉 430000

宫颈高度鳞状上皮内病变 高危型人乳头瘤病毒 宫颈锥切术 持续感染 感染型别 危险因素 阴道微生态环境

武汉市卫计委科研基金资助项目

WG15D11

2024

10.11816/cn.ni.2024-236200

中华医院感染学杂志
中华预防医学会 中国人民解放军总医院

中华医院感染学杂志

CSTPCD北大核心
影响因子：1.885
ISSN：1005-4529
年,卷(期)：2024.34(6)
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