宫颈环形电切术联合重组人干扰素a2b对宫颈鳞状上皮内瘤变患者疗效及对阴道微生态的影响

doi:10.3969/j.issn.1006-6233.2022.12.028

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摘要 目的: 观察宫颈环形电切术(LEEP术)联合重组人干扰素a2b凝胶对宫颈鳞状上皮内瘤变(CIN)患者疗效及对阴道微生态的影响。方法: 选取2019年6月至2021年12月我院收治的106例CIN患者作为观察对象,随机数字表法简单分为观察组(n=53,LEEP术+重组人干扰素a2b凝胶治疗)和对照组(n=53,LEEP术治疗),连续治疗4周。治疗后3个月,比较两组HPV转阴及阴道微生态恢复情况,比较治疗前、治疗后3个月两组炎性因子及免疫功能水平。结果: 治疗后3个月,观察组HPV转阴率(66.04%)及总有效率(96.23%)高于对照组(26.42%及64.15%)(P<0.05)。观察组阴道微生态正常或恢复占比(92.45%)高于对照组(30.38%),阴道分泌物pH(4.19±0.52)及Nugent评分(2.31±0.45)分低于对照组[(4.46±0.50)及(2.93±0.52)分],差异有统计学意义(P<0.05)。两组宫颈局部微生态环境中INF-γ、IL-12、血清CD4⁺、CD4⁺/CD8⁺水平高于治疗前,且两组治疗前后差值组间比较,差异有统计学意义(P<0.05);两组宫颈局部微生态环境中IL-4、TNF-α、血清CD8⁺水平低于治疗前,且两组治疗前后差值组间比较,差异有统计学意义(P<0.05)。结论: LEEP术+重组人干扰素a2b有利于CIN患者HPV转阴率的提高,降低炎症反应,增强免疫功能,改变预后。

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	吴婉如
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关键词 ：宫颈鳞状上皮内瘤变, 宫颈环形电切术, 重组人干扰素a2b凝胶, 疗效, 阴道微生态

Abstract：Objective: To observe the efficacy of loop electrosurgical excision procedure (LEEP) combined with recombinant human interferon a2b gel on patients with cervical intraepithelial neoplasia (CIN) and its effects on vaginal microecology. Methods: 106 patients with CIN who were treated in the hospital between June 2019 and December 2021 were selected as the observation subjects, and they were simply divided into the observation group (n=53, LEEP+recombinant human interferon a2b gel) and the control group (n=53, LEEP) using the random number table method. Both groups were continuously treated for 4 weeks. The HPV negative conversion and vaginal microecology recovery at 3 months after treatment, and inflammatory factors and immune function before treatment and at 3 months after treatment were compared between the two groups. Results: At 3 months after treatment, the HPV negative conversion rate and effective rate were 66. 04% and 96. 23% in the observation group, which were higher than 26. 42% and 64. 15% in the control group (P<0. 05). The proportion of normal or recovered vaginal microecology (92. 45% vs 30. 38%) in the observation group was higher while the vaginal secretion pH [(4. 19±0. 52) vs (4. 46±0. 50)] and Nugent score [(2. 31±0. 45) points vs (2. 93±0. 52) points] were lower (P<0. 05) compared to the control group. The levels of INF-γ, IL-12, serum CD4⁺ and CD4⁺/CD8⁺ in the local cervical microecological environment of the two groups were higher than those before treatment, and the differences before and after treatment in the two groups were statistically significant (P<0. 05). The levels of IL-4, TNF-α and serum CD8⁺ in the local cervical microecological environment of both groups were lower than those before treatment, and the differences in the two groups before and after treatment were statistically significant (P<0. 05). Conclusion: LEEP+recombinant human interferon a2b is beneficial to increasing the negative conversion rate of HPV, reducing the inflammatory response, enhancing the immune function, and changing the prognosis of patients.

Key words： CIN LEEP Recombinant human interferon a2b gel Efficacy Vaginal microecology

基金资助:广东省医学科学技术研究基金项目,(编号:B2021317)

通讯作者: 邓勍

引用本文:

吴婉如, 邓勍, 张翠雯. 宫颈环形电切术联合重组人干扰素a2b对宫颈鳞状上皮内瘤变患者疗效及对阴道微生态的影响[J]. 河北医学, 2022, 28(12): 2081-2085.
WU Wanru, DENG Qing, ZHANG Cuiwen. Efficacy of LEEP Combined with Recombinant Human Interferon a2b on Patients with Cervical Intraepithelial Neoplasia and Its Effects on Vaginal Microecology. HeBei Med, 2022, 28(12): 2081-2085.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.12.028 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I12/2081