女性外陰尖銳濕疣患者宮頸HPV和沙眼衣原體感染的流行病學(xué)調(diào)查及重組人干擾素α-2b陰道泡騰膠囊治療HPV感染的效果觀察
發(fā)布時(shí)間：2018-08-28 10:29
【摘要】：[目的]尖銳濕疣(Condyloma acuminate,CA)和泌尿生殖道沙眼衣原體(Chlamydia trachomatis,Ct)感染是常見(jiàn)的性傳播疾病,但兩者共同發(fā)病的資料尚不清楚。高危型人乳頭瘤病毒(human papillomavirus,HPV)持續(xù)感染是宮頸癌發(fā)生的必要條件。有報(bào)道,高危HPV和沙眼衣原體共同感染在宮頸上皮內(nèi)瘤變及宮頸癌發(fā)生中起到重要作用。本研究旨在獲得天津醫(yī)科大學(xué)總醫(yī)院性病門(mén)診女性外陰尖銳濕疣患者宮頸HPV合并沙眼衣原體共同感染的流行病學(xué)資料,了解該部分人群宮頸有無(wú)HPV感染及HPV基因分型,探討對(duì)該部分人群進(jìn)行常規(guī)宮頸HPV和沙眼衣原體篩查、及時(shí)治療并隨訪的意義,以在一定程度上降低宮頸癌。同時(shí)觀察重組人干擾素ɑ-2b陰道泡騰膠囊治療宮頸HPV感染的療效,為治療HPV感染積累臨床經(jīng)驗(yàn)。[方法]1.收集自2015年6月至2016年6月期間就診于天津醫(yī)科大學(xué)總醫(yī)院性病門(mén)診,初次確診為外陰尖銳濕疣的女性患者的宮頸脫落細(xì)胞樣本,PCR法檢測(cè)樣本HPV基因及分型和沙眼衣原體的DNA;同時(shí)記錄由婦科轉(zhuǎn)診我科的確診為外陰尖銳濕疣女性患者宮頸HPV的檢測(cè)結(jié)果,并統(tǒng)計(jì)感染率。2.將上述HPV陽(yáng)性者隨機(jī)分成治療組和對(duì)照組,治療組患者給予重組人干擾素ɑ-2b陰道泡騰膠囊80萬(wàn)IU治療,其中,僅有低危型HPV感染者每月連續(xù)應(yīng)用12天,有高危型HPV感染者每月連續(xù)應(yīng)用20天,規(guī)律治療3個(gè)月,停藥4周后復(fù)查宮頸HPV,記錄結(jié)果對(duì)比觀察療效。對(duì)照組不使用干擾素治療。[結(jié)果]1.123例初次確診外陰尖銳濕疣的女性患者中,宮頸樣本HPV感染,沙眼衣原體感染及兩者共同感染的百分率分別是88.6%(109/123),22.7%(20/88)及22.7%(20/88)。其中75.6%(93/123)的女性宮頸感染了高危型HPV,所有Ct陽(yáng)性者均表現(xiàn)為宮頸HPV-DNA陽(yáng)性。2.123例女性尖銳濕疣患者宮頸樣本中,65.0%(80/123)表現(xiàn)為混合HPV基因型感染,13.0%(16/123)僅有LR-HPV感染,10.6%(13/123)僅有HRHPV感染。最常見(jiàn)的HR-HPV亞型為HPV 16(31/109),52(16/109),18(14/109),51(13/109),58(13/109),最常見(jiàn)的LR-HPV的亞型為HPV 11(41/109),6(63/109)。3.20例宮頸HPV陽(yáng)性患者接受重組人干擾素ɑ-2b的陰道泡騰膠囊規(guī)律治療后并接受回訪,發(fā)現(xiàn)用藥后三個(gè)月治療組清除率為:HR-HPV的清除率為61.5%,LR-HPV的清除率為70.4%,總清除率為65.2%,;20例對(duì)照組患者4個(gè)月后HPV感染無(wú)明顯變化。[結(jié)論]外陰尖銳濕疣女性患者22.7%宮頸合并沙眼衣原體感染,88.6%合并宮頸HPV感染,其中高危型達(dá)75.6%,65.0%表現(xiàn)為宮頸混合HPV基因型感染。因此,在尖銳濕疣女性患者中開(kāi)展沙眼衣原體及宮頸HPV檢測(cè)很有必要,以及時(shí)發(fā)現(xiàn)和治療沙眼衣原體感染及HPV感染,爭(zhēng)取在一定程度上降低C A的復(fù)發(fā)率和宮頸癌的發(fā)生風(fēng)險(xiǎn),但仍需要大樣本數(shù)據(jù),長(zhǎng)期的隨訪研究證實(shí)。20例應(yīng)用重組人干擾素ɑ-2b陰道泡騰膠囊治療的患者HPV均有不同程度轉(zhuǎn)陰,總清除率為65.2%。重組人干擾素ɑ-2b陰道泡騰膠囊可作為治療宮頸HP V感染的候選藥物之一。
[Abstract]:[objective] Condyloma acuminatum (Condyloma acuminate,CA) and urogenital chlamydia trachomatis (Chlamydia trachomatis,Ct) infection are common sexually transmitted diseases, but the data of both are not clear. Persistent infection of high-risk human papillomavirus (human papillomavirus,HPV) is a necessary condition for cervical cancer. It is reported that high risk HPV and chlamydia trachomatis co-infection play an important role in cervical intraepithelial neoplasia and cervical cancer. The purpose of this study was to obtain the epidemiological data of cervical HPV co-infection with chlamydia trachomatis in female vulvar condyloma acuminatum outpatient clinic of General Hospital of Tianjin Medical University, and to find out whether there was HPV infection and HPV genotyping in the cervix. To explore the significance of routine cervical HPV and chlamydia trachomatis screening, timely treatment and follow-up, in order to reduce cervical cancer to a certain extent. To observe the efficacy of recombinant human interferon-2b vaginal effervescent capsule in the treatment of cervical HPV infection and to accumulate clinical experience in the treatment of HPV infection. [methods] 1. Collected from June 2015 to June 2016, the STD clinic of General Hospital of Tianjin Medical University, Detection of HPV gene and typing of cervical exfoliated cells in female patients with vulvar condyloma acuminatum for the first time and DNA; of chlamydia trachomatis simultaneously recorded female patients with vulvar condyloma acuminatum diagnosed by gynecological referral department Cervical HPV test results, And the infection rate. The above HPV positive patients were randomly divided into treatment group and control group. Patients in the treatment group were treated with recombinant human interferon-2b vaginal effervescent capsule for 800000 IU. Among them, only low-risk HPV infected patients were treated continuously for 12 days per month. Patients with high risk HPV infection were treated regularly for 3 months for 20 consecutive days each month. The results of cervical HPV, records were compared and observed after 4 weeks of withdrawal. The control group was not treated with interferon. [results] the rates of HPV infection, chlamydia trachomatis infection and co-infection were 88.6% (109 / 123) and 22.7% (20 / 88) in 1.123 female patients with vulvar condyloma acuminatum for the first time. Among them, 75.6% (93 / 123) of women had cervical infection with high-risk HPV,. All the Ct positive women showed positive HPV-DNA in cervix. 65.0% (80 / 123) of cervix samples of condyloma acuminatum showed mixed HPV genotype infection (13.0% (16 / 123) only LR-HPV infection 10.6% (13 / 123) only HRHPV infection. The most common subtype of HR-HPV was HPV 16 (31 / 109), 52 (16 / 109), 18 (14 / 109), 51 (13 / 109), 58 (13 / 109), and the most common subtype of LR-HPV was HPV 11 (41 / 109) 6 (63 / 109) .3.20 patients with positive cervical HPV received regular treatment with recombinant human interferon-2b vaginal effervescent capsules and were interviewed back. It was found that the clearance rate of the treatment group was 61.5% HR-HPV, the clearance rate of LR-HPV was 70.4, the total clearance rate was 65.2% and 20 cases of control group had no significant change in HPV infection after 4 months. [conclusion] 22.7% of female patients with vulvar condyloma acuminatum combined with chlamydia trachomatis infection 88. 6% of them were associated with cervical HPV infection. Therefore, it is necessary to detect chlamydia trachomatis and cervical HPV in female patients with condyloma acuminatum in order to detect and treat chlamydia trachomatis infection and HPV infection in time, and to reduce the recurrence rate of CA and the risk of cervical cancer to a certain extent. However, large sample data were still needed. Long-term follow-up study confirmed that. 20 patients treated with recombinant human interferon-2b vaginal effervescent capsule had varying degrees of HPV conversion to negative, the total clearance rate was 65.2%. Recombinant human interferon-2b vaginal effervescent capsule can be used as a candidate for the treatment of cervical HP V infection.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R752.53
本文編號(hào)：2209123
[Abstract]:[objective] Condyloma acuminatum (Condyloma acuminate,CA) and urogenital chlamydia trachomatis (Chlamydia trachomatis,Ct) infection are common sexually transmitted diseases, but the data of both are not clear. Persistent infection of high-risk human papillomavirus (human papillomavirus,HPV) is a necessary condition for cervical cancer. It is reported that high risk HPV and chlamydia trachomatis co-infection play an important role in cervical intraepithelial neoplasia and cervical cancer. The purpose of this study was to obtain the epidemiological data of cervical HPV co-infection with chlamydia trachomatis in female vulvar condyloma acuminatum outpatient clinic of General Hospital of Tianjin Medical University, and to find out whether there was HPV infection and HPV genotyping in the cervix. To explore the significance of routine cervical HPV and chlamydia trachomatis screening, timely treatment and follow-up, in order to reduce cervical cancer to a certain extent. To observe the efficacy of recombinant human interferon-2b vaginal effervescent capsule in the treatment of cervical HPV infection and to accumulate clinical experience in the treatment of HPV infection. [methods] 1. Collected from June 2015 to June 2016, the STD clinic of General Hospital of Tianjin Medical University, Detection of HPV gene and typing of cervical exfoliated cells in female patients with vulvar condyloma acuminatum for the first time and DNA; of chlamydia trachomatis simultaneously recorded female patients with vulvar condyloma acuminatum diagnosed by gynecological referral department Cervical HPV test results, And the infection rate. The above HPV positive patients were randomly divided into treatment group and control group. Patients in the treatment group were treated with recombinant human interferon-2b vaginal effervescent capsule for 800000 IU. Among them, only low-risk HPV infected patients were treated continuously for 12 days per month. Patients with high risk HPV infection were treated regularly for 3 months for 20 consecutive days each month. The results of cervical HPV, records were compared and observed after 4 weeks of withdrawal. The control group was not treated with interferon. [results] the rates of HPV infection, chlamydia trachomatis infection and co-infection were 88.6% (109 / 123) and 22.7% (20 / 88) in 1.123 female patients with vulvar condyloma acuminatum for the first time. Among them, 75.6% (93 / 123) of women had cervical infection with high-risk HPV,. All the Ct positive women showed positive HPV-DNA in cervix. 65.0% (80 / 123) of cervix samples of condyloma acuminatum showed mixed HPV genotype infection (13.0% (16 / 123) only LR-HPV infection 10.6% (13 / 123) only HRHPV infection. The most common subtype of HR-HPV was HPV 16 (31 / 109), 52 (16 / 109), 18 (14 / 109), 51 (13 / 109), 58 (13 / 109), and the most common subtype of LR-HPV was HPV 11 (41 / 109) 6 (63 / 109) .3.20 patients with positive cervical HPV received regular treatment with recombinant human interferon-2b vaginal effervescent capsules and were interviewed back. It was found that the clearance rate of the treatment group was 61.5% HR-HPV, the clearance rate of LR-HPV was 70.4, the total clearance rate was 65.2% and 20 cases of control group had no significant change in HPV infection after 4 months. [conclusion] 22.7% of female patients with vulvar condyloma acuminatum combined with chlamydia trachomatis infection 88. 6% of them were associated with cervical HPV infection. Therefore, it is necessary to detect chlamydia trachomatis and cervical HPV in female patients with condyloma acuminatum in order to detect and treat chlamydia trachomatis infection and HPV infection in time, and to reduce the recurrence rate of CA and the risk of cervical cancer to a certain extent. However, large sample data were still needed. Long-term follow-up study confirmed that. 20 patients treated with recombinant human interferon-2b vaginal effervescent capsule had varying degrees of HPV conversion to negative, the total clearance rate was 65.2%. Recombinant human interferon-2b vaginal effervescent capsule can be used as a candidate for the treatment of cervical HP V infection.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R752.53
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