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| Follow-Up Observation of Vaginal Microenvironment after LEEP and Analysis of Risk Factors for Persistent HPV Infection |
| WANG Xiaoli, YAN Yifen |
| Shiyan People's Hospital, Hubei Shiyan 442000, China |
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Abstract Objective: To investigate the follow-up observation of vaginal microenvironment after loop electrosurgical excision procedure (LEEP) and the influencing factors of persistent human papillomavirus (HPV) infection. Methods: From January 2019 to September 2021, 98 patients with LEEP in our hospital were selected, according to the return visit of one year after LEEP, 20 patients with persistent HPV infection,the differences of clinical data between persistent HPV infection and HPV negative patients were analyzed, and the differences of vaginal microenvironment before and 1 week after LEEP were analyzed, and the differences of vaginal microenvironment between patients with persistent HPV infection and those with negative HPV during follow-up visit were also analyzed. Results: Compared with negative HPV patients, the age ≥ 40 years old, vaginal wall involvement, multiple infection of HPV before operation, HPV viral load ≥ 100 RLU/CO before operation, and positive rate of incisional marginof patients with persistent HPV infection were 80.00%, 65.00%, 60.00%, 65.00% and 65.00% respectively, which were significantly higher (P<0.05). Compared with negative HPV patients, the rates of condom use and anti HPV drugs use in patients with persistent HPV infection were 40.00% and 35.00%, respectively, which were significantly lower (P<0.05). Logistic regression showed that age, multiple infection of HPV before operation, load of HPV virus before operation, incision margin, and use of anti HPV after operation were the influencing factors of persistent infection of HPV (P＜0.05). After LEEP, the proportion of colony density Ⅲ～Ⅳ, flora diversity Ⅲ～Ⅳ, pH>4.5, salivary glycosidase positive, hydrogen peroxide positive, leukocyte esterase positive were 21.43%, 26.53%, 32.65%, 37.76%, 31.63% and 25.51% respectively, which were significantly lower than those before LEEP (P<0.05). Compared with negative HPV patients, the proportion of vaginal microenvironment flora density III-IV, flora diversity III-IV, pH>4.5, salivary glycosidase positive, hydrogen peroxide positive, and leukocyte esterase positiveduring follow-up visit of persistent HPV infection were 60.00%, 55.00%, 60.00%, 55.00%, 50.00%, and 60.00% which were significantly higher (P<0.05). Conclusion: The persistent infection of HPV is affected by the patient's age and multiple HPV infections and so on. The vaginal microenvironment is significantly improved after LEEP, and the vaginal microenvironment of patients with persistent HPV infection at the time of follow-up visits were significantly worse than that of patients with negative HPV.
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2023, Vol. 29 
