高级别上皮内瘤变和不同型别人乳头瘤病毒感染患者阴道微生态特征分析

探讨高级别上皮内瘤变（high level squamous intraepithelial lesion，HSIL）患者阴道微生态的特征及不同型别人乳头瘤病毒（human papilloma virus，HPV）感染对阴道微生态的影响。

收集我院健康女性（对照组，n=54）和HSIL患者（HSIL组，n=54）的阴道分泌物样本，提取其DNA，通过HPV试剂盒检测HPV型别，并使用16S rRNA基因高通量测序分析阴道菌群的组成结构及特征。

HSIL组女性HPV阳性率为88.9%，对照组女性HPV阳性率仅有11.1 %。与对照组相比，HSIL组女性阴道乳杆菌属相对丰度降低，加德纳菌属、普雷沃菌属、双歧杆菌属相对丰度增多，但差异均无统计学意义（均P＞0.05）。与HPV Others组相比，HPV CR组女性阴道阿托波菌属相对丰度显著降低（t=2.067，P=0.043）；加德纳菌属、链球菌属、肠球菌属相对丰度降低，双歧杆菌属相对丰度升高，但差异均无统计学意义（均P＞0.05）。

HSIL患者HPV感染率升高，不同型别HPV感染会对阴道微生态产生影响，提示对阴道微生态进行干预可能对宫颈病变产生调节作用。

The impacts of high level squamous intraepithelial lesion and different subtypes of human papilloma virus infection on vaginal microbiota

ObjectiveTo observe the characteristics of vaginal microbiota in patients with high level squamous intraepithelial lesion (HSIL) and the impacts of different human papilloma virus (HPV) infection on vaginal microbiota. MethodsThe vaginal secretion samples from healthy women (control group, n=54) and HSIL patients (HSIL group, n=54) were collected. The HPV subtypes were detected using HPV kits. The composition, structure and characteristics of vaginal microbiota were detected with 16S rRNA gene high-throughput sequencing. Results The HPV positive rate was 88.9% in HSIL group vs 11.1% in control group. Compared with control group, the relative abundance of vaginal Lactobacillus in HSIL group decreased, while those of vaginal Gardnerella, Prevotella and Bifidobacterium increased, but with no statistically significant differences (all P＞0.05). Compared with the HPV Others group, the HPV CR group showed a significant decrease in the abundance of vaginal Atobobacter (t=2.067, P=0.043); those of vaginal Gardnerella, Streptococcus and Enterococcus decreased, while that of Bifidobacterium increased, but with no significant differences (all P＞0.05). ConclusionThe HPV infection rate increases in HSIL patients. Different HPV subtype infection can impact the vaginal microbiota, suggesting that intervention in vaginal microbiota may have regulatory effect on cervical lesions.