HPV感染病人阴道灌洗液IL-10、IFN-γ、TNF-α水平与微生态菌群分布的关系研究

杜娟; 史昭; 杨淑英; 肖爽; 杨敏

HPV感染病人阴道灌洗液IL-10、IFN-γ、TNF-α水平与微生态菌群分布的关系研究

Study on the relationship between the levels of IL-10, IFN-γ and TNF-α in vaginal lavage fluid and the distribution of microbiota in patients with HPV infection

摘要

摘要:
目的： 探讨人乳头瘤病毒（HPV）感染病人阴道灌洗液白细胞介素-10（IL-10）、γ干扰素（IFN-γ）、肿瘤坏死因子-α（TNF-α）水平与微生态菌群分布的相关性。
方法： 选择因宫颈炎或可疑有宫颈病变的200例病人作为观察对象，根据是否感染高危型HPV分为对照组（高危HPV阴性）113例，和HPV感染组（高危HPV阳性）87例，检测阴道分泌物微生物分布，ELISA法检测阴道灌洗液中IL-10、IFN-γ、TNF-α水平，分析IL-10、IFN-γ、TNF-α水平与阴道微生态菌群分布相关性。
结果： 2组宫颈病变严重程度比较差异有统计学意义（P ＜ 0.01）。2组霉菌、滴虫、支原体感染比例差异无统计学意义（P ＞ 0.05），HPV感染组乳酸杆菌病人比例显著低于对照组，细菌性阴道炎、衣原体、解脲支原体病人比例显著高于对照组（P ＜ 0.05 ~ P ＜ 0.01）。与对照组比较，HPV感染组病人阴道灌洗液IL-10水平显著升高，IFN-γ 、TNF-α水平显著降低（P ＜ 0.01）。HPV感染组病人阴道灌洗液IL-10水平与乳酸杆菌感染呈负相关关系，与细菌性阴道炎、衣原体、解脲支原体阳性感染率呈正相关关系，IFN-γ、TNF-α水平与乳酸杆菌感染呈正相关关系，与细菌性阴道炎、衣原体、解脲支原体阳性感染率呈负相关系（P ＜ 0.01）。
结论： HPV感染病人阴道灌洗液IL-10水平升高，IFN-γ、TNF-α水平降低，与病人阴道微生态菌群分布有关，对宫颈病变的防治具有指导意义。

Abstract:
Objective To investigate the correlation between the levels of interleukin-10 (IL-10), interferon gamma (IFN-γ), tumor necrosis factor -α (TNF-α) in vaginal lavage fluid and the distribution of microbial flora in patients with human papillomavirus (HPV) infection.
Methods A total of 200 patients with cervicitis or suspected cervical lesions were selected as the observation objects, and they were divided into control group (113 cases with high-risk HPV negative) and HPV infection group (87 cases with high-risk HPV positive) according to whether they were infected with high-risk HPV. The microbial distribution of vaginal secretions was detected. The levels of IL-10, IFN-γ, TNF-α in vaginal lavage fluid were detected by ELISA, and the correlation between the levels of IL-10, IFN-γ, TNF-α and the distribution of vaginal microbiota was analyzed.
Results There was significant difference in the severity of cervical lesions between the two groups (P ＜ 0.01). There was no significant difference in the proportion of mold, trichomonas and mycoplasma infection between the two groups (P ＞ 0.05). The proportion of Lactobacillus patients in HPV infection group was significantly lower than that in the control group, and the proportion of bacterial vaginitis, chlamydia and Ureaplasma urealyticum patients was significantly higher than that in the control group (P ＜ 0.05 ~ P ＜ 0.01). Compared with the control group, the level of IL-10 in vaginal lavage fluid of patients with HPV infection group was significantly increased, and the levels of IFN -γ and TNF -α were significantly decreased (P ＜ 0.01). The level of IL-10 in vaginal lavage fluid of patients in HPV infection group was negatively correlated with the infection rate of Lactobacillus, and positively correlated with the positive infection rate of bacterial vaginitis, chlamydia and Ureaplasma urealyticum. The levels of IFN-γ and TNF-α were positively correlated with the infection rate of Lactobacillus, and negatively correlated with the positive infection rate of bacterial vaginitis, chlamydia and Ureaplasma urealyticum (P ＜ 0.01).
Conclusions The level of IL-10 in vaginal lavage fluid of patients with HPV infection increases, while the levels of IFN -γ and TNF -α decrease, which is related to the distribution of vaginal microbiota in patients, and has guiding significance for the prevention and treatment of cervical lesions.

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