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目的分析合并人乳头瘤病毒(riskhumanpapilloma virus,HPV)感染的宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)患者采用宫颈环形电切术(loop electrosurgical excision procedure,LEEP)治疗后的HPV感染及疾病转归情况。方法选取旬阳计划生育服务站2011年1月-2014年1月收治的CIN患者共200例,所有患者均接受LEEP治疗,根据组织学分期分为CINⅠ期、CINⅡ期和CINⅢ期,观察分析3组患者术前及术后3、6、12个月HPV的感染情况。根据HPV亚型检测情况分为低危组和高危组,对比两组患者术后转归情况。结果 CINⅠ期、CINⅡ期和CINⅢ期3组患者术后3、6、12个月的HPV阳性率均显著低于术前镜检(P<0.01);3组患者组间术前镜检、术后3、6、12个月HPV阳性率CINⅢ组>CINⅡ组>CINⅠ组(P<0.01),术后12个月HPV转阴率为CINⅠ组>CINⅡ组>CINⅢ组(P<0.05)。治疗后6个月时,低危组消退率为34.21%,进展率为5.26%,高危组为14.29%和10.00%,两组比较,差异有统计学意义(P<0.05);治疗后12个月时,低危组消退率为69.74%,进展率为3.95%,高危组为42.86%和2.86%,两组比较,差异有统计学意义(P<0.01)。结论LEEP术可降低CIN患者的HPV感染率;CIN病理级别越低,其HPV感染率和术后残存率越低;HPV高危型感染是CIN进展的重要危险因素。
Objective To analyze the changes of HPV infection and disease after cervical loop epithelial neoplasia (CIN) complicated with human papillomavirus (HPV) infection by loop electrosurgical excision procedure (LEEP) Return to the situation. Methods A total of 200 CIN patients were enrolled in the Xunyang Family Planning Service Station from January 2011 to January 2014. All patients received LEEP and were divided into CINⅠ, CINⅡ and CINⅢ according to the histological staging. Observation and Analysis3 Group of patients preoperative and postoperative 3,6,12 months of HPV infection. According to the detection of subtypes of HPV, the patients were divided into low-risk group and high-risk group. The postoperative outcomes of the two groups were compared. Results The positive rates of HPV at 3, 6 and 12 months after operation in CINⅠ, CINⅡ and CINⅢ groups were significantly lower than those before operation (P <0.01). The preoperative examination, The positive rates of HPV in CINⅢ, CINⅡ, CINⅠ (P <0.01) at 3, 6 and 12 months after operation were significantly higher than those in CINⅠ, CINⅡ and CINⅢ at 12 months after operation (P <0.05). At 6 months after treatment, the regression rate of low-risk group was 34.21%, the rate of progress was 5.26%, and the high-risk group was 14.29% and 10.00% respectively. There was significant difference between the two groups (P <0.05) Month, the low risk group, the regression rate was 69.74%, the progress rate was 3.95%, high risk group was 42.86% and 2.86%, the two groups, the difference was statistically significant (P <0.01). Conclusion LEEP can reduce the infection rate of HPV in CIN patients. The lower the pathological grade of CIN is, the lower the HPV infection rate and postoperative residual rate are. The high risk HPV infection is an important risk factor of CIN.