高危型人乳头瘤病毒阳性鳞状上皮内病变与阴道微生态指标的相关性研究OA

Objective To investigate the correlation between high-risk human papillomavirus(HR-HPV)positive squa-mous intraepithelial lesion and vaginal microecological indicators,and to provide clinical evidence for the prevention and intervention of cervical lesions.Methods A total of 62 patients with HR-HPV-positive squamous intraepithelial lesions ad-mitted to the Second Affiliated Hospital of Mudanjiang Medical University from January 2024 to December 2025 were selected as the study group.Meanwhile,200 healthy subjects with negative HR-HPV and negative thin-prep cytologic test were enrolled as the control group.A case-control study was conducted to divide the subjects into two groups.Cervical ex-foliated cells were collected from both groups for HR-HPV genotyping.Vaginal secretions were sampled to evaluate the following indicators:vaginal flora diversity,Lactobacillus count,vaginal pH,leucocyte esterase,siali-dase levels,as well as the infection rates of bacterial vagi-nosis and vulvovaginal candidiasis.The two groups were compared in terms of vaginal flora diversity,Lactobacillus count,vaginal pH,positive rates of leucocyte esterase and sialidase,and infection rates of bacterial vaginosis and vulvovaginal can-didiasis.Logistic regression analysis was performed to identify the factors associated with the occurrence of HR-HPV-posi-tive squamous intraepithelial lesions.Results Univariate analysis showed statistically significant differences between the study group and the control group in vaginal flora diversity,Lactobacillus count,vaginal pH,positive rates of leucocyte es-terase and sialidase,and infection rates of bacterial vaginosis and vulvovaginal candidiasis(P<0.05).The vaginal bacterial diversity in the study group was higher than that in the control group,while the number of Lactobacillus was lower than that in the control group,the differences were statistically significant(P<0.05).The vaginal pH,positive rate of leucocyte es-terase,and the positive rate of sialidase in the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).The infection rates of bacterial vaginosis and vulvovaginal candidiasis in the study group were also higher than those in the control group,and the differences were statistically significant(P<0.05).Multivari-ate logistic regression analysis revealed that Lactobacillus count,vaginal pH,and bacterial vaginosis infection were inde-pendent influencing factors for HR-HPV-positive squamous intraepithelial lesions(P<0.05).Conclusion Vaginal microe-cological imbalance is closely related to the occurrence of HR-HPV-positive squamous intraepithelial lesion.Decreased Lactobacillus count,elevated vaginal pH value and bacterial vaginosis infection can serve as important reference indicators for predicting the risk of cervical lesions,and regulating vaginal microecological homeostasis may be a potential intervention target for preventing the progression of cervical lesions.