阴道微生态与宫颈上皮内瘤变的相关性研究

摘要

Objective To Explore the correlation between vaginal microflora and cervical intraepithelial neoplasia ( CIN) .Methods Clinical data of 158 gynecologic outpatients whose results of vaginal microbiological examination of cer -vical biopsy were cervicitis or CIN in the First Affiliated Hospital of Xi′an Jiaotong University during Jan .and Oct.of 2017 were collected and analyzed .Results In the 158 patients ,there were 67 cases with cervicitis ,91 cases with CIN .The inci-dence of vaginal infectious disease in CIN patients was higher than that in cervicitis patients [65.9%(60/91) vs 43.3%(29/67)](P <0.01).The incidence of vaginal infectious disease in CINⅠ was 65.9%(29/44),in CINⅡ-Ⅲ was 66.0%(31/47).There was no significant difference between the two groups (P>0.05).Compared with normal vaginal mi-croflora,the incidence of CIN in bacterial vaginosis (BV),intermediate BV and vulvovaginal candidiasis (VVC) was higher than the incidence of cervicitis (P<0.05).And there was no significant difference in the incidence of high-grade cervical lesions and low-grade cervical lesions in BV,intermediate type BV and VVC(P>0.05).Compared with the normal vaginal microecological indicators,the incidence of CIN increased in patients with elevated pH (P<0.05),while those with siali-dase positive,β-glucuronidase positive, and acetaminoglucosidase positive did not have increased risk of CIN (P>0.05). Conclusion BV,intermediate type BV ,VVC increase the risk of CIN , and they are not related with the incidence of CIN high grade lesions.pH increases the risk of CIN;sialidase,β-glucuronidase,acetamino glycosidase are not related with the incidence of CIN .%目的 探讨阴道微生态与宫颈上皮内瘤变(CIN)的相关性.方法 收集2017年1—10月于西安交通大学第一附属医院妇科门诊就诊,病理学检查结果确诊为宫颈炎或CIN的158例患者的阴道微生态检测结果及相关临床资料并进行分析.结果 158例患者中宫颈炎67例,CIN 91例;CIN组阴道感染性疾病发生率高于宫颈炎组[65.9%(60/91)比43.3%(29/67)](P<0.01);CINⅠ级组阴道感染性疾病发生率为65.9%(29/44),CINⅡ~Ⅲ级组为66.0%(31/47),差异无统计学意义(P>0.05).与阴道微生态正常者相比,细菌性阴道病(BV),中间型BV和外阴阴道假丝酵母菌病(VVC)中CIN的发生率高于宫颈炎(P<0.05),宫颈高度病变和低度病变的发生率比较差异无统计学意义(P>0.05).以阴道微生态功能指标正常者作为对照,pH值升高患者CIN发生率增加(P<0.05);而唾液酸苷酶阳性、β-葡萄糖醛酸苷酶阳性、乙酰氨基葡萄糖苷酶阳性不增加CIN的发生风险(P>0.05).结论 阴道感染性疾病中,BV、中间型BV、VVC增加CIN的发生风险,与CIN高度病变的发生不相关;阴道微生态功能指标中,pH值增加CIN发生风险;唾液酸苷酶、β-葡萄糖醛酸苷酶、乙酰氨基葡萄糖苷酶与CIN的发生不相关.