摘要
目的探讨妊娠期妇女子宫体检感染病毒种类、高危型人乳头病毒(HR-HPV)载量及预后情况,为其临床诊疗提供参考。方法选取2017年6月至2019年6月在武穴市第一人民医院妇产科进行子宫体检的218例妊娠期妇女为研究对象。根据第二代杂交捕获法(HC-2)检测结果,将所有妇女分为正常组(31例)、低度鳞状上皮内瘤变(LSIL)组(58例)、高度鳞状上皮内瘤变(HSIL)组(84例)和宫颈癌组(45例)。比较四组妊娠期妇女HR-HPV感染种类、载量及其预后情况。结果正常组妊娠期妇女的感染类型主要为HPV-31、HPV-33、HPV-35,LSIL组、HSIL组和宫颈癌组妊娠期妇女的感染类型主要为HPV-16、HPV-18;LSIL组、HSIL组和宫颈癌组妊娠期妇女的单一感染率和多重感染率明显高于正常组,且宫颈癌组的单一感染率明显高于LSIL组、HSIL组,HSIL组的单一感染率明显高于LSIL组,宫颈癌组的多重感染率明显高于LSIL组,差异均有统计学意义(P<0.05);LSIL组、HSIL组和宫颈癌组妊娠期妇女的HR-HPV载量均明显高于正常组,且宫颈癌组的HR-HPV载量明显高于LSIL组、HSIL组,HSIL组的HR-HPV载量明显高于LSIL组,差异均有统计学意义(P<0.05);产后3个月,LSIL组、HSIL组和宫颈癌组妊娠期妇女的单一感染率和多重感染率均明显高于正常组,且宫颈癌组的单一感染率明显高于LSIL组、HSIL组,HSIL组的单一感染率明显高于LSIL组,宫颈癌组的多重感染率明显高于LSIL组,差异均有统计学意义(P<0.05);LSIL组、HSIL组和宫颈癌组妊娠期妇女的自然转阴率分别为48.28%、20.24%、0,均明显低于正常组的74.19%,且宫颈癌组的自然转阴率明显低于LSIL组、HSIL组,HSIL组的自然转阴率明显低于LSIL组,差异均有统计学意义(P<0.05)。结论妊娠期妇女宫颈病变程度越严重,其HR-HPV感染种类及载量越多;且HR-HPV感染率及载量越高,其预后情况越差,检测妊娠期妇女HR-HPV感染种类及载量对其早期诊断、治疗及预后具有重要意义。
Objective To investigate the types of infection virus,high-risk human papilloma virus(HR-HPV)load,and prognosis of pregnant women during uterine examination,and to provide references for clinical diagnosis and treatment.Methods A total of 218 pregnant women who underwent uterine examination in the Department of Obstetrics and Gynecology,Wuxue First People’s Hospital from June 2017 to June 2019 were selected as the research subjects.According to the results of the second generation hybrid capture method(HC-2),the women were divided into normal group(31 cases),low-grade squamous intraepithelial neoplasia(LSIL)group(58 cases),highly squamous intraepithelial neoplasia(HSIL)group(84 cases),and cervical cancer group(45 cases).The types,load,and prognosis of HR-HPV infection in pregnant women were compared among the four groups.Results The infection types of pregnant women in the normal group were mainly HPV-31,HPV-33,and HPV-35,and the infection types of pregnant women in the LSIL group,HSIL group and cervical cancer group were mainly HPV-16,HPV-18.The single infection rate and multiple infections in the LSIL group,HSIL group,and cervical cancer group were significantly higher than those in the normal group,and the single infection rate in the cervical cancer group were significantly higher than that in the LSIL and HSIL groups;the single infection rate in the HSIL group was significantly higher than that in the LSIL group,and the multiple infection rate in the cervical cancer group was significantly higher than that in the LSIL group;the differences were statistically significant(P<0.05).The HR-HPV load of LSIL group,HSIL group and cervical cancer group were significantly higher than that of the normal group,the HR-HPV load of the cervical cancer group were significantly higher than that of the LSIL group and the HSIL group,and the HR-HPV load of the HSIL group was significantly higher than that of the LSIL group,with statistically significant differences(P<0.05).At 3 months postpartum,the single infection rate and multiple infection rate of pregnant women in the LSIL group,HSIL group,and cervical cancer group were significantly higher than those in the normal group,and the single infection rate in the cervical cancer group were significantly higher than that in the LSIL and HSIL groups;the single infection rate in the HSIL group was significantly higher than that in the LSIL group,and the multiple infections in the cervical cancer group was significantly higher than that in the LSIL group;the differences were statistically significant(P<0.05).The natural conversion rates of pregnant women in the LSIL group,the HSIL group,and the cervical cancer group were 48.28%,20.24%,and 0,which were significantly lower than 74.19%in the normal group,and the natural negative rate were significantly lower in the cervical cancer group than in the LSIL and HSIL groups,and also in the HSIL group than in the LSIL group,with statistically significant differences(P<0.05).Conclusion The more severe the cervical lesions in pregnant women,the more types and loads of HR-HPV infections,and the higher the infection rate and load of HR-HPV,the worse the prognosis.Detection of the type and load of HRHPV infection in pregnant women is of great significance for their early diagnosis,treatment and prognosis.
作者
库瑛
饶亦良
胡蝶
万桃香
KU Ying;RAO Yi-liang;HU Die;WAN Tao-xiang(Department of Obstetrics and Gynecology,Wuxue First People's Hospital,Wuxue 435400,Hubei,CHINA)
出处
《海南医学》
CAS
2020年第14期1840-1843,共4页
Hainan Medical Journal
关键词
妊娠期
高危型人乳头病毒
宫颈上皮内瘤变
宫颈癌
病毒种类
病毒载量
预后
Pregnancy
High-risk human papillomavirus
Cervical intraepithelial neoplasia
Cervical cancer
Virus type
Viral load
Prognosis
