中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2013年
16期
432-433
,共2页
高危型人乳头瘤病毒%宫颈上皮内瘤变%宫颈环形电切术
高危型人乳頭瘤病毒%宮頸上皮內瘤變%宮頸環形電切術
고위형인유두류병독%궁경상피내류변%궁경배형전절술
High risk human papillomavirus%Cervical intraepithelial neoplasia(CIN)%Loop electrosurgical excision procedure(LEEP)
目的探讨高危型人乳头瘤病毒（HR-HPV）感染的宫颈上皮内瘤变（CIN）在宫颈环形电切术（LEEP）治疗术后的转归。方法对109例高危型HPV感染的CINⅠ～Ⅲ患者进行LEEP治疗,术后6个月再次检测其宫颈HR-HPV的平均负荷量，同时行阴道镜检查及宫颈活检。结果 LEEP术后6个月，CIN患者HR-HPV平均负荷量较治疗前均显著降低（P＜0.01）。HR-HPV负荷量转阴率为73.39%（80/109），但各级别CIN HR-HPV转阴率差异无统计学意义（P＞0.05）。根据LEEP术后6个月宫颈HPV-DNA负荷量，低度负荷量组8例中，7例为TCT正常者，1例为CIN；中度负荷量组10例中，7例为TCT正常者，3例为CIN；重度负荷量组11例中，7例为TCT正常者，4例为CIN。中、高度HR-HPV病毒负荷组与低度HR-HPV病毒负荷组之间CIN转归存在差异（P＜0.05）。结论 LEEP是目前治疗CIN有效的方法，HR-HPV感染的宫颈CIN在LEEP术后，HR-HPV负荷量明显降低，宫颈CIN的转归与持续HR-HPV负荷量的高低密切相关，HC-Ⅱ动态监测HR-HPV负荷量，对术后宫颈CIN预后有指导意义。
目的探討高危型人乳頭瘤病毒（HR-HPV）感染的宮頸上皮內瘤變（CIN）在宮頸環形電切術（LEEP）治療術後的轉歸。方法對109例高危型HPV感染的CINⅠ～Ⅲ患者進行LEEP治療,術後6箇月再次檢測其宮頸HR-HPV的平均負荷量，同時行陰道鏡檢查及宮頸活檢。結果 LEEP術後6箇月，CIN患者HR-HPV平均負荷量較治療前均顯著降低（P＜0.01）。HR-HPV負荷量轉陰率為73.39%（80/109），但各級彆CIN HR-HPV轉陰率差異無統計學意義（P＞0.05）。根據LEEP術後6箇月宮頸HPV-DNA負荷量，低度負荷量組8例中，7例為TCT正常者，1例為CIN；中度負荷量組10例中，7例為TCT正常者，3例為CIN；重度負荷量組11例中，7例為TCT正常者，4例為CIN。中、高度HR-HPV病毒負荷組與低度HR-HPV病毒負荷組之間CIN轉歸存在差異（P＜0.05）。結論 LEEP是目前治療CIN有效的方法，HR-HPV感染的宮頸CIN在LEEP術後，HR-HPV負荷量明顯降低，宮頸CIN的轉歸與持續HR-HPV負荷量的高低密切相關，HC-Ⅱ動態鑑測HR-HPV負荷量，對術後宮頸CIN預後有指導意義。
목적탐토고위형인유두류병독（HR-HPV）감염적궁경상피내류변（CIN）재궁경배형전절술（LEEP）치료술후적전귀。방법대109례고위형HPV감염적CINⅠ～Ⅲ환자진행LEEP치료,술후6개월재차검측기궁경HR-HPV적평균부하량，동시행음도경검사급궁경활검。결과 LEEP술후6개월，CIN환자HR-HPV평균부하량교치료전균현저강저（P＜0.01）。HR-HPV부하량전음솔위73.39%（80/109），단각급별CIN HR-HPV전음솔차이무통계학의의（P＞0.05）。근거LEEP술후6개월궁경HPV-DNA부하량，저도부하량조8례중，7례위TCT정상자，1례위CIN；중도부하량조10례중，7례위TCT정상자，3례위CIN；중도부하량조11례중，7례위TCT정상자，4례위CIN。중、고도HR-HPV병독부하조여저도HR-HPV병독부하조지간CIN전귀존재차이（P＜0.05）。결론 LEEP시목전치료CIN유효적방법，HR-HPV감염적궁경CIN재LEEP술후，HR-HPV부하량명현강저，궁경CIN적전귀여지속HR-HPV부하량적고저밀절상관，HC-Ⅱ동태감측HR-HPV부하량，대술후궁경CIN예후유지도의의。
?Objective?To study on the development of cervical intraepithelial neoplasia (CIN) with high risk human papillomavirus (HR-HPV) infection after loop electrosurgical excision procedure (LEEP). Methods A total of 109 women with high risk HPV infection and CINⅠ/Ⅱ/Ⅲ confirmed by histology were treated by LEEP. Six months later high risk HPV load was measured by HybirdcaptureⅡsystem again. The colposcopy and cervical biopsy were performed in the meantime. Results The average high risk human papil omavirus load of CIN patients were decreased after treatment of LEEP significantly after six moths (P<0.01). HPV loading turned to be negative postoperatively in 73.39% (80/109) of the women,but the negative conversion rate was no significant differences among CINⅠ/Ⅱ/Ⅲ groups(P>0.05).After LEEP treatment, in the low viral loading group, 7 cases turned to chronic cervictis and 1 remained CIN; in the mediumin viral loading group, 7 cases turned to chronic cervictis,3 cases remained CIN;the high viral loading group, 7 cases turned to chronic cervictis; 4 cases remained CIN. The Positive Rate of CIN between the three groups was significant (P<0.05). Conclusions LEEP is the effective treatment of cervical lesion and can reduce the viral loading of HR-HPV at CIN significantly. The prognosis of CIN is related to high viral loading of HR-HPV after LEEP therapy.HC-II examination is an useful measures in the prognosis of HR-HPV infection of patients with CIN.
