| 李俐,丁玲,吕元婧,王铭,刘春亮,韩阳,王金桃.阴道微环境改变与HPV16感染在宫颈上皮内瘤变中的作用及其交互效应[J].中华流行病学杂志,2018,39(11):1486-1490 |
| 阴道微环境改变与HPV16感染在宫颈上皮内瘤变中的作用及其交互效应 |
| Interaction between vaginal micro-environment alterations and HPV16 infection in cervical intraepithelial neoplasia |
| 收稿日期:2018-04-03 出版日期:2018-11-15 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.11.013 |
| 中文关键词: 宫颈上皮内瘤变 HPV16 阴道微环境 交互作用 |
| 英文关键词: Cervical intraepithelial neoplasia HPV16 Vaginal micro-environment Interaction |
| 基金项目:国家卫生和计划生育委员会公益性行业科研专项（201402010）；国家自然科学基金（81473060，81273157）；全球健康促进研究基金 |
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| 中文摘要: |
| 目的 探讨阴道微环境改变和HPV16感染在宫颈上皮内瘤变中的作用及其交互效应。方法 研究对象来源于课题组前期在山西省建立的宫颈病变研究队列，包括623例正常宫颈（NC）妇女、303例低度宫颈上皮内瘤变（CINⅠ）患者和93例高度宫颈上皮内瘤变（CINⅡ/Ⅲ）患者。在收集其人口学特征和宫颈上皮内瘤变相关因素资料的同时，采用导流杂交技术检测HPV16感染状况，应用需氧菌性阴道炎/细菌性阴道病联合检测试剂盒检测阴道分泌物中的H2O2、β-葡萄糖醛酸苷酶、凝固酶、唾液酸酐酶和白细胞酯酶，以及阴道pH值和清洁度。应用SPSS 22.0软件进行数据的录入和资料分析。结果 随着宫颈病变的进展，HPV16感染率（趋势性χ2=55.45，P<0.001）、H2O2 （趋势性χ2=26.19，P<0.001）、pH值（趋势性χ2=5.06，P=0.024）、阴道清洁度（趋势性χ2=19.55，P<0.001）、β-葡萄糖醛酸苷酶（趋势性χ2=17.52，P<0.001）、唾液酸酐酶（趋势性χ2=14.90，P<0.001）的异常率均逐渐升高，而凝固酶和白细胞酯酶异常率未见相应趋势。广义多因子降维模型交互作用分析显示，在CINⅠ组，HPV16感染与H2O2、β-葡萄糖醛酸苷酶、凝固酶、唾液酸酐酶异常呈交互作用，在CINⅡ/Ⅲ组，HPV16感染与阴道清洁度、H2O2、β-葡萄糖醛酸苷酶、唾液酸酐酶异常呈交互作用。结论 阴道微环境改变和HPV16感染均可增加宫颈病变的发病风险，且在宫颈上皮内瘤变中具有交互作用。 |
| 英文摘要: |
| Objective To explore the effect of vaginal micro-environment alterations and HPV16 infection and their interaction in the progression of cervical intraepithelial neoplasia. Methods The participants of this study came from the cervical lesions study cohort in Shanxi province, including 623 women with normal cervical (NC), 303 patients with pathogenically diagnosed low-grade cervical intraepithelial neoplasia (CINⅠ) and 93 patients with pathogenically diagnosed high-grade cervical intraepithelial neoplasia (CINⅡ/Ⅲ). The data of the demographic characteristics of the study subjects and factors related to cervical intraepithelial neoplasia were collected, and HPV16 infection were detected by using flow-through hybridization technology and H2O2, β-glucuronidase, clotting enzyme, neuraminidase and leucocyte esterase in vaginal secretions were detected by using the combined detection kit of aerobic vaginitis and bacterial vaginosis. pH value and vaginal cleanliness were also detected at the same time. The database was established and analyzed by SPSS statistical software (version 22.0). Results The HPV16 infection rate (trend χ2=55.45, P<0.001) and the abnormal rates of H2O2 (trend χ2=26.19, P<0.001), pH (trend χ2=5.06, P=0.024), vaginal cleanliness (trend χ2=19.55, P<0.001), β-glucuronidase (trend χ2=17.52, P<0.001) and neuraminidase (trend χ2=14.90, P<0.001) increased gradually along with the severity of cervical intraepithelial neoplasia, but the abnormal rates of clotting enzyme and leucocyte esterase showed no same trend. The results of GMDR model analysis showed that there was interaction between HPV16 infection and abnormalities of H2O2, β-glucuronidase, clotting enzyme and neuraminidase in CINⅠ group, and the interaction between HPV16 infection and the abnormalities of vaginal cleanliness, H2O2, β-glucuronidase and neuraminidase in CIN Ⅱ/Ⅲ group. Conclusion Our findings indicated that the vaginal micro-environment alterations and HPV16 infection could increase the risk of cervical intraepithelial neoplasia, and they might have an important synergistic effect in the progression of cervical intraepithelial neoplasia. |
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