[1]田美月a,王 源a,陈迎弟b,等.HR-HPV 持续感染患者阴道微生态与阴道灌洗液CCL28 水平表达的相关性研究[J].现代检验医学杂志,2024,39(04):155-160.[doi:10.3969/j.issn.1671-7414.2024.04.028]
　TIAN Meiyuea,WANG Yuana,CHEN Yingdib,et al.Study on the Correlation between the Vaginal Microecology and CCL28 Levels Expression in the Vaginal Lavage Fluid of Patients with Persistent HR-HPV Infection[J].Journal of Modern Laboratory Medicine,2024,39(04):155-160.[doi:10.3969/j.issn.1671-7414.2024.04.028]
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HR-HPV 持续感染患者阴道微生态与阴道灌洗液CCL28 水平表达的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年04期
页码:
155-160
栏目:
论著
出版日期:
2024-07-15

文章信息/Info

Title:
Study on the Correlation between the Vaginal Microecology and CCL28 Levels Expression in the Vaginal Lavage Fluid of Patients with Persistent HR-HPV Infection
文章编号:
1671-7414（2024）04-155-06
作者:
田美月a; 王 源a; 陈迎弟b; 刘秀荣a
（唐山市妇幼保健院a. 妇科；b. 生殖遗传科，河北唐山 063000）
Author(s):
TIAN Meiyuea;  WANG Yuana;  CHEN Yingdib;  LIU Xiuronga
(a. Department of Gynecology；b. Department of Reproductive Genetics, Tangshan Maternal and Child Health Hospital, Hebei Tangshan 063000, China)
关键词:
高危人乳头瘤病毒; 阴道微生态; CC 趋化因子配体28
分类号:
R373；R446.61
DOI:
10.3969/j.issn.1671-7414.2024.04.028
文献标志码:
A
摘要:
目的 探究高危人乳头瘤病毒（high-risk human papillomavirus，HR-HPV）持续感染患者阴道微生态与阴道灌洗液CC 趋化因子配体28（CC chemokine ligand 28，CCL28）水平表达的关系。方法 选取2021 年4 月～ 2023 年4 月唐山市妇幼保健院的132 例HR-HPV 感染患者作为研究对象。根据复查结果将HR-HPV 感染患者分为单次感染组和持续感染组。比较两组的CCL28 和阴道微生态指标。用Logistic 回归分析HR-HPV 持续感染的风险因素。用Logistic 回归拟合限制性立方样条分析CCL28 与HR-HPV 持续感染的水平效应关系。用Spearman 和多元线性回归分析CCL28 与阴道微生态指标的关系。结果 患者复查后，单次感染84 例（63.64%），持续感染48 例（36.36%）。持续感染组的菌群密集度Ⅰ级（54.17% 比16.67%）、菌群多样性Ⅰ级（47.92%）、pH 值＞ 4.5（47.92%）、过氧化氢阳性（54.17%）和阴道微生态失衡（66.67%）的占比及CCL28 水平[83.63（77.11，99.62）ng/L] 均高于单次感染组[16.76%，21.43%，15.48%，30.95%，41.67%，71.11（58.12,82.16）ng/L]，差异具有统计学意义（χ2/Z=5.064 ～ 20.338，均P ＜ 0.05）。Logistic 回归分析结果显示，菌群密集度Ⅰ级（OR=3.556，95%CI：1.241 ～ 10.194，P=0.018）、pH 值＞ 4.5（OR=4.366，95%CI：1.164 ～ 16.380，P=0.029）和高CCL28 水平（OR=1.048，95%CI：1.018 ～ 1.080，P=0.002）是HR-HPV 感染患者持续感染的独立危险因素。Logistic 回归拟合限制性立方样条结果显示，CCL28 与HR-HPV 持续感染呈线性关系（非线性检验χ2=0.61，P=0.437）。Spearman 相关分析结果显示，CCL28 与年龄（r=0.205，P=0.018）、菌群密集度（r=0.429，P ＜ 0.001）、菌群多样性（r=0.389，P ＜ 0.001）、pH 值（r=0.357，P ＜ 0.001）、过氧化氢（r=0.409，P ＜ 0.001）、白细胞酯酶（r=0.392，P ＜ 0.001）和阴道微生态（r=0.473，P ＜ 0.001）均呈正相关关系。线性回归分析结果显示，菌群密集度（β=12.295，P=0.003）和菌群多样性（β=9.196，P=0.032）与CCL28 独立相关。结论 菌群密集度和菌群多样性与CCL28 独立相关。菌群密集度Ⅰ级、pH 值＞ 4.5 和高CCL28 水平提示HR-HPV 感染患者持续感染风险增加。
Abstract:
Objective To investigate the relationship between the vaginal microecology and CC chemokine ligand 28 (CCL28) expression levels in the vaginal lavage fluid of patients with persistent high-risk human papillomavirus (HR-HPV) infection. Methods A total of 132 patients with HR-HPV infection at Tangshan Maternal and Child Health Hospital from April 2021 to April 2023 were selected as study subjects. Patients with HR-HPV infection were categorized into the single infection group and the persistent infection group according to the review results. The CCL28 and vaginal microecological indicators of the two groups were compared. Logistic regression was used to analyze the risk factors for persistent HR-HPV infection. The dose-response relationship between CCL28 and persistent HR-HPV infection was analyzed by fitting restricted cubic splines with logistic regression. Spearman and multiple linear regression were used to analyze the relationship between CCL28 and vaginal microecological indicators. Results After the reexamination of patients, there were 84 (63.64%) cases of single infection and 48 (36.36%) cases of persistent infection. The percentage of colony density grade I (54.17% vs 16.67%), colony diversity grade I (47.92%), pH > 4.5 (47.92% ), hydrogen peroxide positivity (54.17%), and vaginal microecological imbalance (66.67%), and the level of CCL28 [83.63 (77.11, 99.62) ng/L] in the persistent infection group were higher than those of the single infection group [16.76%, 21.43%, 15.48%, 30.95%, 41.67%, 71.11（58.12,82.16）ng/L], and the differences were statistically significant (χ2/Z=5.064 ～ 20.338, all P<0.05). Logistic regression analysis showed that colony density grade I (OR=3.556, 95% CI：1.241 ～ 10.194, P=0.018), PH > 4.5 (OR=4.366, 95% CI: 1.164 ～ 16.380, P=0.029), and high CCL28 levels (OR=1.048, 95% CI：1.018 ～ 1.080, P=0.002) were independent risk factors for persistent infection in HR-HPV-infected patients. Logistic regression fitting restricted cubic splines showed a linear relationship between CCL28 and persistent HR-HPV infection (nonlinear test χ2=0.61, P=0.437). Spearman correlation analysis results showed that CCL28 was positively correlated with age (r=0.205, P=0.018), colony density (r=0.429, P<0.001), colony diversity (r=0.389, P<0.001), pH (r=0.357, P<0.001), hydrogen peroxide (r=0.409, P<0.001), leukocyte esterase (r=0.392, P<0.001), and vaginal microecology (r=0.473, P<0.001). Linear regression analysis showed that colony density (β=12.295, P=0.003) and colony diversity (β=9.196, P=0.032) were independently associated with CCL28. Conclusion Colony density and colony diversity were independently correlated with CCL28. Colony density grade I, pH > 4.5, and high CCL28 levels suggest an increased risk of persistent infection in patients with HR-HPV infection.

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备注/Memo

备注/Memo:
基金项目：河北省医学科学研究课题计划项目（20221750）。
作者简介：田美月（1989-），女，硕士，主治医师，研究方向：妇科疾病临床诊疗工作，E-mail: tianmy89_ts@126.com。
更新日期/Last Update: 2024-07-15