目的：探讨高危型人乳头瘤病毒（HPV）感染者宫颈病变严重程度与阴道内环境的关系。方法选取425例高危型 HPV 感染患者，均行宫颈液基薄层细胞学检查（TCT）以了解宫颈病变程度，并行阴道内环境监测，对比不同程度宫颈病变者阴道内环境指标的差异。结果TCT 检查：正常13例，炎症132例，CINⅠ级111例，CINⅡ级90例，CIN Ⅲ级54例，宫颈癌25例。阴道内环境检测：阴道清洁度≤Ⅱ级者194例，pH 值≤4．5者202例，菌群分布≤Ⅰ级者244例，滴虫感染者56例，假丝酵母菌感染者48例，阴道炎患者240例。不同程度宫颈病变阴道内环境指标对比：阴道清洁度≥Ⅲ级、pH 值≤4．5、菌群分布≥Ⅱ级、阴道炎的发生率在不同 TCT 检查结果的患者中差异有统计学意义（均 P ＜0．05），而滴虫感染及假丝酵母菌感染发生率在不同 TCT 检查结果的患者中较差异无统计学意义（P ＞0．05）。结论阴道内环境的改变与 HPV 感染存在密切关系，阴道内环境动态平衡的破坏可能对 HPV 感染者宫颈病变的进一步发展起到了一定促进作用，但两者的确切关系有待进一步研究。%ABSTRACT:Objective To investigate the relationship between the severity of cervical lesions and vaginal environment in patients with high-risk human papillomavirus(HPV)infection.Meth-ods The severity of cervical lesions was detected by thin-layer cytological test(TCT)and vaginal environment was monitored in 425 patients with HPV infection.The indicators of vaginal environ-ment were compared among patients with different degrees of cervical lesions.Results Among the 425 patients,TCT showed normal in 13,inflammation in 132,CIN Ⅰ in 111,CIN Ⅱ in 90, CIN Ⅲ in 54,and cervical cancer in 25.Vaginal environment monitoring showed vaginal cleanli-ness≤Ⅱ in 194,pH≤4.5 in 202,bacterial flora distribution≤Ⅰ in 244,Trichomonas infection in 56,Candida infection in 48,and vaginitis in 240.There were significant differences in the inci-dences of vaginal cleanliness≥Ⅲ,pH≤4.5,bacterial flora distribution≥Ⅱ and vaginitis among patients with different degrees of cervical lesions(P <0.05).No significant differences in the inci-dences of Trichomoniasis or Candida infection among patients with different degrees of cervical le-sions(P >0.05).Conclusion There is a close relationship between changes in vaginal environ-ment and HPV infection.The disorder of dynamic balance of vaginal environment may promote the further development of cervical lesions in patients with HPV infection.However,the exact re-lationship between vaginal environment and HPV infection needs to be further studied.
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